Skip to main content

Advertisement

SpringerLink
Log in

Effect of Metabolic Syndrome on the Clinical Outcomes of Chronic Hepatitis B Patients with Nucleos(t)ide Analogues Treatment

  • Original Article
  • Published:
Digestive Diseases and Sciences Aims and scope Submit manuscript

Abstract

Background

No data are available about the effect of MS on oral nucleos(t)ide analogues (NUCs) treatment and clinical outcomes in chronic hepatitis B (CHB) patients.

Aims

We aimed to elucidate whether coexistence of MS and CHB affects the long-term prognosis of CHB patients with oral NUCs treatment.

Methods

We performed a retrospective data analysis for a total of 587 CHB patients who started oral NUCs treatment for the first time in our institution from January 2006 to March 2016.

Results

Among the 587 patients, 70 (11.9%) had MS, but 517 (88.1%) had no evidence of MS when oral NUCs treatment was initiated. Cumulative occurrence rates of viral breakthrough, genotypic resistance, HCC, disease progression (PD), and overall adverse outcomes (OAO) were significantly higher in CHB patients with MS than in those without MS, although HBV-DNA suppression and cumulative occurrence rates of HBeAg negative conversion and seroconversion were not significantly different between the two groups. The overall survival (OS) was also significantly shorter in CHB patients with MS than in those without MS. Multivariate analysis indicated that the MS was an independent, poor prognostic factor for occurrence of genotypic resistance (adjusted hazard ratio [aHR], 22.3; 95% confidence interval [CI] 6.61–75.02; P < 0.001), HCC (aHR, 3.98; 95% CI 2.07–7.66; P < 0.001), PD (aHR, 6.18; 95% CI 3.43–11.14; P < 0.001), OAO (aHR, 8.10; 95% CI 4.68–14.02; P < 0.001), and OS (aHR, 12.29; 95% CI 2.25–67.24; P < 0.001).

Conclusions

MS is an independent determinant of poor prognosis in CHB patients receiving oral NUCs treatment.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Chan HL, Sung JJ. Hepatocellular carcinoma and hepatitis B virus. Semin Liver Dis. 2006;26:153–161.

    Article  CAS  PubMed  Google Scholar 

  2. Lai CL, Ratziu V, Yuen MF, Poynard T. Viral hepatitis B. Lancet. 2003;362:2089–2094.

    Article  CAS  PubMed  Google Scholar 

  3. Tran TT, Martin P. Hepatitis B: epidemiology and natural history. Clin Liver Dis. 2004;8:255–266.

    Article  PubMed  Google Scholar 

  4. Welzel TM, Graubard BI, Zeuzem S, El-Serag HB, Davila JA, McGlynn KA. Metabolic syndrome increases the risk of primary liver cancer in the United States: a study in the SEER-Medicare database. Hepatology. 2011;54:463–471.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Nderitu P, Bosco C, Garmo H, et al. The association between individual metabolic syndrome components, primary liver cancer and cirrhosis: a study in the Swedish AMORIS cohort. Int J Cancer. 2017;141:1148–1160.

    Article  CAS  PubMed  Google Scholar 

  6. Alberti KG, Zimmet P, Shaw J. Metabolic syndrome—a new world-wide definition. A Consensus Statement from the International Diabetes Federation. Diabet Med. 2006;23:469–480.

    Article  CAS  PubMed  Google Scholar 

  7. Chen CL, Yang HI, Yang WS, et al. Metabolic factors and risk of hepatocellular carcinoma by chronic hepatitis B/C infection: a follow-up study in Taiwan. Gastroenterology. 2008;135:111–121.

    Article  CAS  PubMed  Google Scholar 

  8. Wong GL, Wong VW, Choi PC, et al. Metabolic syndrome increases the risk of liver cirrhosis in chronic hepatitis B. Gut. 2009;58:111–117.

    Article  PubMed  Google Scholar 

  9. Wang CC, Tseng TC, Kao JH. Hepatitis B virus infection and metabolic syndrome: fact or fiction? J Gastroenterol Hepatol. 2015;30:14–20.

    Article  CAS  PubMed  Google Scholar 

  10. Hsiang JC, Wong GL, Chan HL, Chan AW, Chim AM, Wong VW. Metabolic syndrome delays HBeAg seroclearance in Chinese patients with hepatitis B. Aliment Pharmacol Ther. 2014;40:716–726.

    Article  CAS  PubMed  Google Scholar 

  11. Mena A, Pedreira JD, Castro A, Lopez S, Vazquez P, Poveda E. Metabolic syndrome association with fibrosis development in chronic hepatitis B virus inactive carriers. J Gastroenterol Hepatol. 2014;29:173–178.

    Article  CAS  PubMed  Google Scholar 

  12. Huang YW, Wang TC, Lin SC, et al. Increased risk of cirrhosis and its decompensation in chronic hepatitis B patients with newly diagnosed diabetes: a nationwide cohort study. Clin Infect Dis. 2013;57:1695–1702.

    Article  PubMed  Google Scholar 

  13. Yu MW, Shih WL, Lin CL, et al. Body-mass index and progression of hepatitis B: a population-based cohort study in men. J Clin Oncol. 2008;26:5576–5582.

    Article  PubMed  Google Scholar 

  14. Yu MW, Lin CL, Liu CJ, Yang SH, Tseng YL, Wu CF. Influence of metabolic risk factors on risk of hepatocellular carcinoma and liver-related death in men with chronic hepatitis B: a large cohort study. Gastroenterology. 2017;153:e1005.

    Google Scholar 

  15. Wen CP, David Cheng TY, Tsai SP, et al. Are Asians at greater mortality risks for being overweight than Caucasians? Redefining obesity for Asians. Public Health Nutr. 2009;12:497–506.

    Article  PubMed  Google Scholar 

  16. Schuppan D, Afdhal NH. Liver cirrhosis. Lancet. 2008;371:838–851.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  17. Bruix J, Sherman M. Management of hepatocellular carcinoma: an update. Hepatology. 2011;53:1020–1022.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Fisher B, Anderson S, Fisher ER, et al. Significance of ipsilateral breast tumour recurrence after lumpectomy. Lancet. 1991;338:327–331.

    Article  CAS  PubMed  Google Scholar 

  19. Wong GL, Chan HL, Yu Z, et al. Coincidental metabolic syndrome increases the risk of liver fibrosis progression in patients with chronic hepatitis B—a prospective cohort study with paired transient elastography examinations. Aliment Pharmacol Ther. 2014;39:883–893.

    Article  CAS  PubMed  Google Scholar 

  20. Jarcuska P, Drazilova S, Fedacko J, Pella D, Janicko M. Association between hepatitis B and metabolic syndrome: current state of the art. World J Gastroenterol. 2016;22:155–164.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  21. Yoon H, Lee JG, Yoo JH, et al. Effects of metabolic syndrome on fibrosis in chronic viral hepatitis. Gut Liver. 2013;7:469–474.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  22. Paradis V, Perlemuter G, Bonvoust F, et al. High glucose and hyperinsulinemia stimulate connective tissue growth factor expression: a potential mechanism involved in progression to fibrosis in nonalcoholic steatohepatitis. Hepatology. 2001;34:738–744.

    Article  CAS  PubMed  Google Scholar 

  23. Chettouh H, Lequoy M, Fartoux L, Vigouroux C, Desbois-Mouthon C. Hyperinsulinaemia and insulin signalling in the pathogenesis and the clinical course of hepatocellular carcinoma. Liver Int. 2015;35:2203–2217.

    Article  CAS  PubMed  Google Scholar 

  24. Asselah T, Rubbia-Brandt L, Marcellin P, Negro F. Steatosis in chronic hepatitis C: why does it really matter? Gut. 2006;55:123–130.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  25. Lonardo A, Adinolfi LE, Loria P, Carulli N, Ruggiero G, Day CP. Steatosis and hepatitis C virus: mechanisms and significance for hepatic and extrahepatic disease. Gastroenterology. 2004;126:586–597.

    Article  CAS  PubMed  Google Scholar 

  26. Chung WG, Kim HJ, Choe YG, et al. Clinical impacts of hazardous alcohol use and obesity on the outcome of entecavir therapy in treatment-naive patients with chronic hepatitis B infection. Clin Mol Hepatol. 2012;18:195–202.

    Article  PubMed  PubMed Central  Google Scholar 

  27. Marcellin P, Gane E, Buti M, et al. Regression of cirrhosis during treatment with tenofovir disoproxil fumarate for chronic hepatitis B: a 5-year open-label follow-up study. Lancet. 2013;381:468–475.

    Article  CAS  PubMed  Google Scholar 

  28. Varbobitis I, Papatheodoridis GV. The assessment of hepatocellular carcinoma risk in patients with chronic hepatitis B under antiviral therapy. Clin Mol Hepatol. 2016;22:319–326.

    Article  PubMed  PubMed Central  Google Scholar 

  29. Sohn W, Cho JY, Kim JH, et al. Risk score model for the development of hepatocellular carcinoma in treatment-naive patients receiving oral antiviral treatment for chronic hepatitis B. Clin Mol Hepatol. 2017;23:170–178.

    Article  PubMed  PubMed Central  Google Scholar 

  30. Nestel P, Lyu R, Low LP, et al. Metabolic syndrome: recent prevalence in East and Southeast Asian populations. Asia Pac J Clin Nutr. 2007;16:362–367.

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Preventive Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea

    Nam Hee Kim

  2. Division of Gastroenterology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 29, Saemunan-Ro, Jongno-Gu, Seoul, 03181, Korea

    Yong Kyun Cho, Byung Ik Kim & Hong Joo Kim

Authors
  1. Nam Hee Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Yong Kyun Cho
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Byung Ik Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Hong Joo Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Hong Joo Kim.

Ethics declarations

Conflict of interest

All authors declare that they have no competing conflicts of interests.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary Fig. 1

(A) CR rate (P < 0.198) and (B) ALT normalization rate (p < 0.001) in CHB patients with vs. without metabolic syndrome (TIFF 1726 kb)

Supplementary Fig. 2

(A) Cumulative occurrence rates of HBeAg negative conversion (P = 0.434) and (B) seroconversion (P = 0.119) in CHB patients with vs. without metabolic syndrome (TIFF 1003 kb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Kim, N.H., Cho, Y.K., Kim, B.I. et al. Effect of Metabolic Syndrome on the Clinical Outcomes of Chronic Hepatitis B Patients with Nucleos(t)ide Analogues Treatment. Dig Dis Sci 63, 2792–2799 (2018). https://doi.org/10.1007/s10620-018-5165-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10620-018-5165-6

Keywords

Search

Navigation