Study of Metabolic Associated Fatty Liver Disease (MAFLD) and Pancreatic Steatosis in Obese Versus Lean Chronic Hepatitis B Patients

Abstract

Background: Recently, the coexistence of chronic hepatitis B (CHB) and metabolic associated fatty liver disease (MAFLD) has garnered increasing attention. Nevertheless, the frequency of MAFLD among individuals with HBV infection and its relationship with pancreatic steatosis remain subjects of ongoing debate. Aims of study: This study aims to investigate the prevalence of MAFLD, hepatic fibrosis, and pancreatic steatosis in obese versus lean patients with CHB, including both treatment-naive individuals and those receiving first-line nucleos(t)ide analogue therapy. Patients and Methods: This cross-sectional study encompassed 217 CHB participants were placed into two groups in accordance to their BMI. Hepatic steatosis (HS) and stiffness were determined via transient elastography, while the presence of pancreatic steatosis (PS) was evaluated via ultrasonography. Results: Our findings revealed that the frequency of significant HS among participants with CHB was 37.3%, which is less than that reported in the general Egyptian population. PS was observed in 64.1% of overweight/obese patients and 25.8% of lean patients. HS demonstrated a positive correlation with age, BMI, T2DM, pancreatic steatosis, and dyslipidemia, and an inverse association with HBV DNA levels (p < 0.05), but was not significantly associated with hepatic fibrosis (p > 0.05). Multivariate logistic regression analysis determined diabetes mellitus, pancreatic steatosis, increased BMI or waist circumference, elevated cholesterol and triglyceride levels, and reduced HDL levels as independent determinants with hepatic steatosis. Conclusion: Our data suggest that the frequency of HS is decreased in participants with CHB than in the general Egyptian population. DM, fatty pancreas, increase in BMI or waist circumference, elevated level of cholesterol and triglycerides and low level of HDL were independent indicators for hepatic steatosis. However, the coexistence of HS with HBV did not show association with developing fibrosis.