关键词: 慢性乙型病毒性肝炎, 非酒精性脂肪性肝病, Fibro-Touch, 减重, 肝纤维化, 脂肪肝程度

Abstract: Objective To evaluate the impact of weight loss to mitigate the progression of liver fibrosis and the accumulation of liver fat in chronic hepatitis B (CHB) and/or non-alcoholic fatty liver disease (NAFLD) patients. Methods The participants were divided into three groups: group A with CHB (52 cases), group B with NAFLD (58 cases), and group C with CHB concurrent with NAFLD (50 cases). Fibro-Touch was used to non-invasively detect the degree of liver fibrosis and fatty liver disease by measurement of liver stiffness (LSM) and controlled attenuation coefficient (CAP), The general liver function indicators and blood levels of lipids of these participants were tested before and after intervention. According to the guidance, the interventions on weight loss were conducted in three groups of cases for 6 months. The effectiveness of intervention was defined as a decrease in BMI for ≥2 kg/m². Results The values of LSM and ALT in the effective group B decreased, and the values of LSM and ALT before weight loss in the effective group B were (9.8±1.9) kPa and (31.8±10.6) U/L, respectively. After six months of weight loss, the values of LSM and ALT in group B were (8.0±1.5) kPa and (31.8±10.6) U/L, respectively, and the differences were statistically significant (P values 0.002 and 0.001, respectively). The CAP value of the effective intervention group decreased significantly in the three groups. The CAP value of the group A before weight loss was (230.2±10.3) db/m, and the CAP after six months was (212.7±10.1) db/m, P=0.003. The CAP value of the group B before weight loss was (303.9±26.2) db/m. After six months, the CAP was (261.8±18.6) db/m, P=0.008. Before the weight loss in group C, the CAP was (289.7±31.6) db/m and after six months, the CAP was (250.1±21.6) db/m, P=0.016 (P<0.05). In the effective intervention group, before weight loss, TG and LDL-c in group A were (1.3±0.4) and (2.2±0.7) mmol/L, and after six months, TG and LDL-c in group A were (0.9±0.2) and (1.7±0.5) mmol/L. Before weight loss, TG and LDL-c of group B were (2.3±1.2) and (2.8±1.1) mmol/L, and after six months, TG and LDL-c of group B were (1.7±0.7) and (2.3±0.7) mmol/L. Before weight loss, TG and LDL-c of group C were (1.9±1.0) and (2.1±0.6) mmol/L, and after six months, TG and LDL-c of group C were (1.2±0.6) and (1.6±0.5) mmol/L, and blood lipid (TG and LDL-c) of the effective intervention group were decreased significantly (P<0.05). Conclusion Effective weight loss intervention can significantly alleviate the degree of liver steatosis in patients with NAFLD, improve liver fibrosis, and improve liver function and blood lipid indexes, further delaying the progression of such diseases. Effective weight loss intervention decreased liver steatosis in patients with CHB and NAFLD, improved the blood lipid index, of which the improvement of TG and LDL-c were more obvious.

Key words: Chronic hepatitis B, Non-alcoholic fatty liver disease, Fibro-Touch, Weight loss, Hepatic fibrosis