Kronik Hepatit B Etyolojili Kronik Karaciğer Hastalığında Obezite Bazlı Metabolik Profile Göre Non-invaziv Biyokimyasal Fibrozis Belirteçlerinin Karşılaştırılması

Year 2024, , 113 - 116, 30.10.2024

Sedat Çiftel

https://doi.org/10.61845/agrimedical.1562045

Abstract

Amaç: Bu çalışmanın amacı, obez ve obez olmayan Kronik Hepatit B (KHB) hastalarında fibrozis belirteçlerini karşılaştırarak obezitenin fibroz üzerindeki etkisini araştırmaktır.
Gereç ve Yöntem: Bu çalışmaya toplam 172 KHB'li (ortalama yaşı 50,6 ± 9,4 olan) hasta dahil edildi. Hastalar iki gruba ayrıldı: Obez (n=72) ve Obez Olmayan (n=100). Dahil etme kriterlerini kronik hepatit B tanısı almış ve ≤ 50 IU/mL veya saptanamayan HBV-DNA'sı olanlar, dışlama kriterlerini ise CHB dışında diğer kronik hastalık ve gebelik oluşturmaktaydı. Boy, vücut ağırlığı ve bel çevreleri ölçüldü. BKİ ≥30 kg/m2 obez olarak sınıflandırıldı. Alanin Aminotransferaz (ALT), Aspartat Aminotransferaz (AST), Gama glutamil transferaz, albümin, bilirubin ve protrombin zamanı analiz edildi. Fibrozis-4 skoru (FIB-4), Yaş x AST / trombosit sayısı x √(ALT) formülüyle hesaplandı ve AST-Trombosit Oranı İndeksi (APRI), [AST/AST (normalin üst sınırı)]/trombosit sayısı formülüyle hesaplandı.
Bulgular: AST obez hastalarda anlamlı olarak daha yüksekti (p<0.001). FIB-4 (p=0.002) ve APRI (p=0.007) skorları obez grupta daha yüksekti. Karaciğerin sağ lobunun uzunluğu obez grupta anlamlı şekilde fazlaydı (p=0.035).
Sonuç: Obezite, KHB hastalarında artmış fibrozis progresyonuyla ilişkilidir.Bu bulgular, obezitenin KHB hastalarında karaciğer hasarını şiddetlendirebileceğini ve fibrozis ilerlemesini yavaşlatmak için bu popülasyonda obezitenin tedavisinin önemini vurgulamaktadır. Obezitenin fibrozis üzerindeki etkisini hafifletmeye yönelik tedavi stratejilerini yönetmek için daha fazla araştırmaya ihtiyaç vardır.

Keywords

Kronik Hepatit B, Obezite, APRI, FIB-4

Comparison of Non-invasive Biochemical Fibrosis Markers According to Obesity-Based Metabolic Profile in Chronic Liver Disease with Chronic Hepatitis B Etiology

Abstract

Aim: The aim of this study is to investigate the impact of obesity on fibrosis by comparing fibrosis markers between obese and non-obese patients with Chronic Hepatitis B (CHB).
Material and Method: A total of 172 CHB (50.6±9.4 mean aged) patients were included in this retrospective study. The patients were divided into two groups: Obese (n=72) and Non-obese (n=100). Inclusion criteria were those diagnosed with chronic hepatitis B and ≤ 50 IU/mL or undetectable HBV-DNA, and exclusion criteria were other chronic diseases other than CHB and pregnancy. The height, body weight, and waist circumferences were measured. BMI ≥30 kg/m2 was classified as the obese group. Alanine Aminotransferase (ALT), Aspartate Aminotransferase (AST), Gamma-glutamyl transferase, albumin, bilirubin, and prothrombin time were analyzed. Fibrosis-4 score (FIB-4) was calculated with the formula Age x AST / platelet count x √(ALT), and AST-Platelet Ratio Index (APRI) was calculated with the formula [AST/AST (upper limit of normal)]/ platelet count.
Results: AST levels were significantly higher in obese patients (p<0.001). FIB-4 (p=0.002) and APRI (p=0.007) scores were higher in the obese group. The length of the right lobe of the liver was also significantly enlarged in the obese group (p=0.035).
Conclusion: Obesity is associated withz increased fibrosis progression in CHB patients. These findings suggest that obesity may exacerbate liver damage in CHB patients and highlight the importance of managing obesity in this population to slow fibrosis progression. Further research is warranted to manage therapeutic strategies to mitigate the impact of obesity on fibrosis in CHB.

Keywords

Chronic Hepatitis B, Obesity, APRI, FIB-4

Ethical Statement

The study was approved by the Erzurum Health Science University Local Ethics Committee (Decision KAEK 2024/08-152, 14.08.2024).

Supporting Institution

Erzurum Training and Research Hospital

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