Metabolic syndrome as an independent risk factor of liver cirrhosis in patients with chronic hepatitis B
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Chronic hepatitis B (CHB) or C can induce insulin resistance and promote liver steatosis. As it is still unclear whether metabolic syndrome affects the severity of CHB, the relationship between metabolic syndrome and risk of liver cirrhosis was prospectively studied in CHB patients by means of liver stiffness measurement (LSM; estimated from transient elastography) to diagnose early cirrhosis. In total, 1466 patients had reliable LSM and 134 (9%) had adequate liver biopsy. Histologic liver cirrhosis was present in 32/134 (24%) patients and more common among those presenting with metabolic syndrome (38%) versus those without (11%). Probable liver cirrhosis was present in 13% of patients, and metabolic syndrome was more prevalent in patients with probable cirrhosis (24%) versus those without (11%). After adjusting for confounding factors, metabolic syndrome remained independently associated with probable cirrhosis, with a stepwise gradient alongside the defining components (1/5 to 5/5) of the metabolic syndrome. In conclusion, metabolic syndrome appears to be an independent risk factor for liver cirrhosis in CHB patients.
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