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Relationship Between Metabolic Syndrome, Alanine Aminotransferase Levels, and Liver Disease Severity in a Multiethnic North American Cohort With Chronic Hepatitis B.
- Source :
-
Diabetes care [Diabetes Care] 2018 Jun; Vol. 41 (6), pp. 1251-1259. Date of Electronic Publication: 2018 Mar 29. - Publication Year :
- 2018
-
Abstract
- Objective: Metabolic syndrome (MS) is prevalent and is associated with adverse outcomes of liver disease. We evaluated the prevalence of MS and its influence on alanine aminotransferase (ALT) levels and fibrosis, as estimated by the aspartate aminotransferase-to-platelet ratio index (APRI), in a large, multiethnic North American cohort with chronic hepatitis B (HBV) infection.<br />Research Design and Methods: Adults with chronic HBV from 21 centers within the U.S. and Canada were evaluated at baseline and for up to 5 years (median 3.7 years) of follow-up. MS was defined as the presence of at least three of five criteria including waist circumference, blood pressure, glucose, triglyceride, and HDL levels.<br />Results: Analysis included 777 participants, of whom 171 (22%) had MS. Participants with MS (vs. those without MS) were older (median age 54.4 vs. 40.2 years), more often male (61% vs. 51%), and born in the U.S./Canada or had immigrated >20 years ago (60% vs. 43%). MS was not associated with ALT or APRI at baseline. Upon adjusted multivariable analysis of serial ALT values, ALT was significantly higher (mean 12%; P = 0.02) among those with MS at baseline and even higher (mean 19%; P = 0.003) among those with persistent MS compared with those with persistent absence of MS. MS was not associated with serial APRI on follow-up.<br />Conclusions: MS was prevalent in this HBV cohort and was independently associated with higher ALT levels longitudinally. These findings highlight the importance of screening for MS and the potential for MS to influence ALT and its interpretation in the context of HBV treatment decisions.<br /> (© 2018 by the American Diabetes Association.)
- Subjects :
- Adolescent
Adult
Aged
Alanine Transaminase metabolism
Aspartate Aminotransferases
Cohort Studies
Female
Hepatitis B, Chronic metabolism
Humans
Liver Cirrhosis metabolism
Liver Cirrhosis physiopathology
Male
Metabolic Syndrome physiopathology
Middle Aged
North America epidemiology
Platelet Count
Prevalence
United States
Young Adult
Alanine Transaminase blood
Hepatitis B, Chronic blood
Hepatitis B, Chronic physiopathology
Liver Cirrhosis blood
Metabolic Syndrome blood
Subjects
Details
- Language :
- English
- ISSN :
- 1935-5548
- Volume :
- 41
- Issue :
- 6
- Database :
- MEDLINE
- Journal :
- Diabetes care
- Publication Type :
- Academic Journal
- Accession number :
- 29599296
- Full Text :
- https://doi.org/10.2337/dc18-0040