Corelation of hepatic steatosis with ınsulin resistance,necroinflammation and fibrozis in patient with chronic hepatitis B: A prospectif clinical study to asses histological fatty liver related factors.

Introduction: Chronic viral hepatitis and particularly chronic hepatitis B is an important health problem for our country. The relationship between chronic viral hepatitis and hepatic steatosis has been the topic of many papers and particularly the relationship between hepatitis C and fatty liver has been well decomented. However, it has not been possible to show the same relationship between hepatitis B virus and liver steatosis. Also, there are not enough studies in our possesion on this issue.Aim: In the study, our aim is to establish the frequency of hepatic steatosis, the factors causing steatosis and whether there is any relationship between hepatitis B and steatosis.Materials and method: We assesed 88 patients with chronic hepatitis B admitted between December 2006 and January 2008. Liver biopsies were performed in all patients by using Menghini technique, accompanied by liver ultrasonography. Of these patients, 27 were female and 61 were male. Biyopsy specimens were evaluated by the same pathologist. All biochemical and serologic parameters that could cause fattening in patients were assessed.Findings: Steatosis was determined in 28 (% 31.8) of our patients. This proportion was higher compared with general population, but lower with respect to hepatitis C. In our patient population, there were 27(%31) female and 61(%69) males. Steatosis rate was found to be 2.5 times higher in males than in females. We determined that age, body mass index, insulin resistance, hyperlipidemia, and hypertension are significant factors that increase liver steatosis in patient with chronic hepatitis B. We also observed that there was not any difference in terms of steatosis between HBeAg (+) and HBeAg(-) patients, as well as between those who have already received treatment and not. Viral load also has been found to have no effect on liver steatosis.Conclusion: Steatosis could be found in chronic hepatitis B patients. The associated factors of steatosis were found as age, body mass index, insulin resistance, hyperlipidemia, and hypertension. The steatosis depends on patients metabolic factors rather than viral factors. The result we have obtanied seem to be consistent with those reported earlier. Presence of hepatic steatosis may give additional knowledge to clinicians in assesing the severity and prognosis of patients with chronic hepatitis B.