The FIB-4 Index Is a Useful Predictor for the Development of Hepatocellular Carcinoma in Patients with Coexisting Nonalcoholic Fatty Liver Disease and Chronic Hepatitis B
Abstract
:Simple Summary
Abstract
1. Introduction
2. Patients and Methods
2.1. Study Design
2.2. Patients
2.3. Statistical Analysis
2.4. Sensitivity Analysis
3. Results
3.1. Baseline Characteristics
3.2. Risk Factors for Developing HCC in NAFLD–CHB Patients
3.3. Sensitivity Analysis
4. Discussion
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Variables | Before Propensity Score Matching | After Propensity Score Matching * | |||||
---|---|---|---|---|---|---|---|
Total Population (n = 237) | Low FIB-4 Index | High FIB-4 Index | p Value | Low FIB-4 Index | High FIB-4 Index | p Value | |
(n = 147) | (n = 90) | (n = 90) | (n = 90) | ||||
Male (vs. female) | 214 (90.3%) | 137 (93.2%) | 77 (85.6%) | 0.09 | 83 (92.2%) | 77 (85.6%) | 0.24 |
Diabetes mellitus (yes vs. no) | 55 (23.2%) | 36 (24.5%) | 19 (21.1%) | 0.66 | 27 (30.0%) | 19 (21.1%) | 0.13 |
Hypertension (yes vs. no) | 52(21.9%) | 28 (19.0%) | 24 (26.7%) | 0.22 | 23 (25.6%) | 24 (26.7%) | 1.00 |
USG-LC (yes vs. no) | 37 (15.6%) | 18 (12.2%) | 19 (21.1%) | 0.1 | 16 (17.8%) | 19 (21.1%) | 0.85 |
Body mass index (kg/m2) | 25.0 (25.0–26.8) | 25.0 (25.0–26.6) | 25.0 (25.0–27.2) | 0.56 | 25.0 (24.7–26.3) | 25.0 (25.0–27.2) | 0.37 |
Antiviral treatment at baseline (yes vs. no) | 84 (35.4%) | 42 (28.6%) | 42 (46.7%) | 0.007 | 33 (36.7%) | 42 (46.7%) | 0.23 |
Antiviral treatment after baseline (yes vs. no) | 132 (55.7%) | 74 (50.3%) | 58 (64.4%) | 0.047 | 51 (56.7%) | 58 (64.4%) | 0.29 |
Aspirin use (yes vs. no) | 42 (17.7%) | 25 (32.9%) | 17 (18.9%) | 0.85 | 20 (22.2%) | 17 (18.9%) | 0.71 |
Statin use (yes vs. no) | 49 (20.7%) | 32 (21.8%) | 17 (18.9%)) | 0.71 | 20 (22.2%) | 17 (18.9%)) | 0.47 |
HBeAg positivity (yes vs. no) | 121 (51.1%) | 74 (50.3%) | 47 (52.2%) | 0.88 | 45 (50.0%) | 47 (52.2%) | 1 |
HBV DNA > 2000 IU/mL (yes vs. no) | 96 (40.5%) | 61 (41.5%) | 140 (22.2%) | <0.001 | 38 (42.2%) | 35 (38.9%) | 0.65 |
Total bilirubin (IU/L) | 0.8 (0.6–1.0) | 0.8 (0.6–1.0) | 0.8 (0.6–1.1) | 0.26 | 0.8 (0.6–1.1) | 0.8 (0.6–1.1) | 0.23 |
Cholesterol (mg/dL) | 171.0 (151.0–194.5) | 172.0 (150.0–194.5) | 168.0 (151.0–193.0) | 0.77 | 168.0 (150.0–193.0) | 168.0 (151.0–193.0) | 0.82 |
FIB-4 index | 1.6 (1.2–2.0) | 1.3 (1.1–1.5) | 2.2 (1.9–2.6) | <0.001 | 1.4 (1.2–1.6) | 2.2 (1.9–2.6) | <0.001 |
Age (years) | 46.0 (39.0–52.0) | 43.0 (36.5–49.0) | 51.5 (47.0–55.0) | <0.001 | 46.5 (42.0–52.0) | 51.5 (47.0–55.0) | <0.001 |
AST (IU/L) | 30.0 (23.0–46.0) | 25.0 (20.5–31.0) | 49.0 (36.0–67.0) | <0.001 | 24.0 (20.0–30.0) | 49.0 (36.0–67.0) | <0.001 |
ALT (IU/L) | 41.0 (28.0–70.0) | 35.0 (26.0–51.0) | 63.5 (35.0–94.0) | <0.001 | 34.5 (25.0–48.0) | 63.5 (35.0–94.0) | <0.001 |
Platelet (109/L) | 182.0 (150.0–220.0) | 197.0 (161.5–231.5) | 156.5 (121.0–197.0) | <0.001 | 193.0 (155.0–224.0) | 156.5 (121.0–197.0) | 0.001 |
Variables | Univariable Analysis | Multivariable Analysis | ||
---|---|---|---|---|
HR (95% CI) | p Value | aHR (95% CI) | p Value | |
Male (vs. female) | 1.32 (0.17–9.99) | 0.78 | – | – |
Age (years) | 1.00 (0.95–1.07) | 0.88 | – | – |
Diabetes mellitus (yes vs. no) | 1.65 (0.62–4.41) | 0.31 | – | – |
USG-LC (yes vs. no) | 7.59 (2.94–19.59) | <0.001 | 7.84 (3.03–20.28) | <0.001 |
Body mass index ≥25 (vs. <25) | 1.55 (0.61–3.93) | 0.35 | – | – |
Antiviral treatment at baseline (yes vs. no) | 0.65 (0.24–1.73) | 0.39 | – | – |
Antiviral treatment after baseline (yes vs. no) | 2.02 (0.67–6.15) | 0.21 | – | – |
Aspirin use (yes vs. no) | 0.21 (0.03–1.57) | 0.13 | – | – |
Statin use (yes vs. no) | 0.20 (0.02–1.54) | 0.12 | – | – |
HBeAg positivity (yes vs. no) | 0.93 (0.37–2.33) | 0.87 | – | – |
HBV DNA >2000 IU/mL (yes vs. no) | 0.63 (0.24–1.67) | 0.35 | – | – |
High FIB-4 index (≥1.77) (vs. <1.77) | 4.16 (1.37–12.65) | 0.01 | 4.35 (1.42–13.24) | 0.009 |
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Kim, M.; Lee, Y.; Yoon, J.S.; Lee, M.; Kye, S.S.; Kim, S.W.; Cho, Y. The FIB-4 Index Is a Useful Predictor for the Development of Hepatocellular Carcinoma in Patients with Coexisting Nonalcoholic Fatty Liver Disease and Chronic Hepatitis B. Cancers 2021, 13, 2301. https://doi.org/10.3390/cancers13102301
Kim M, Lee Y, Yoon JS, Lee M, Kye SS, Kim SW, Cho Y. The FIB-4 Index Is a Useful Predictor for the Development of Hepatocellular Carcinoma in Patients with Coexisting Nonalcoholic Fatty Liver Disease and Chronic Hepatitis B. Cancers. 2021; 13(10):2301. https://doi.org/10.3390/cancers13102301
Chicago/Turabian StyleKim, Minah, Yeonju Lee, Jun Sik Yoon, Minjong Lee, So Shin Kye, Sun Woong Kim, and Yuri Cho. 2021. "The FIB-4 Index Is a Useful Predictor for the Development of Hepatocellular Carcinoma in Patients with Coexisting Nonalcoholic Fatty Liver Disease and Chronic Hepatitis B" Cancers 13, no. 10: 2301. https://doi.org/10.3390/cancers13102301