Liver histopathological lesions is severe in patients with normal alanine transaminase and low to moderate hepatitis B virus DNA replication

Table 2 Comparison of parameters among patients with alanine transaminase < upper limit of normal and different pathological states (Entire cohort)

Parameters	Liver inflammatory activity		Liver fibrosis		Treatment indication		P value
	< A2 (n = 498)	≥ A2 (n = 136)	< F2 (n = 480)	≥ F2 (n = 154)	< A2 and < F2 (n = 442)	≥ A2 or/and ≥ F2 (n = 192)
Age, mean ± SD, yr	34.68 ± 9.88	39.02 ± 11.10	34.36 ± 9.86	39.52 ± 10.71	34.28 ± 9.84	38.69 ± 10.70	< 0.001, < 0.001, < 0.001
Male, n (%)	268 (53.82)	81 (59.56)	253 (52.71)	96 (62.34)	234 (52.94)	115 (59.90)	0.232, 0.037, 0.105
HBeAg positive, n (%)	354 (71.08)	78 (57.35)	350 (72.92)	82 (53.25)	323 (73.08)	109 (56.77)	0.002, < 0.001, < 0.001
ALB, mean ± SD, g/L	43.06 ± 3.96	41.45 ± 5.75	42.96 ± 4.32	41.95 ± 4.75	43.06 ± 4.01	41.92 ± 5.24	< 0.001, 0.014, 0.003
GLB, mean ± SD, g/L	27.46 ± 4.09	29.14 ± 4.35	27.54 ± 4.06	28.70 ± 4.51	27.49 ± 4.08	28.57 ± 4.38	< 0.001, 0.003, 0.003
AGR, mean ± SD	1.60 ± 0.27	1.46 ± 0.33	1.59 ± 0.28	1.50 ± 0.31	1.60 ± 0.27	1.50 ± 0.32	< 0.001, 0.001, < 0.001
ALT, mean ± SD, U/L	22.81 ± 8.48	27.26 ± 8.07	22.80 ± 8.48	26.80 ± 8.20	22.45 ± 8.43	26.80 ± 8.16	< 0.001, < 0.001, < 0.001
AST, mean ± SD, U/L	22.93 ± 6.24	28.62 ± 14.26	22.79 ± 6.41	28.41 ± 13.26	22.64 ± 6.26	27.63 ± 12.45	< 0.001, < 0.001, < 0.001
ALP, mean ± SD, U/L	68.68 ± 24.45	80.67 ± 29.48	68.62 ± 23.35	79.49 ± 31.80	68.58 ± 23.86	77.41 ± 29.68	< 0.001, < 0.001, < 0.001
GGT, mean ± SD, U/L	20.24 ± 13.58	34.91 ± 33.78	19.87 ± 13.63	34.34 ± 31.87	19.91 ± 13.78	31.38 ± 29.60	< 0.001, < 0.001, < 0.001
WBC count, mean ± SD, × 109/L	5.40 ± 1.41	5.33 ± 1.53	5.43 ± 1.44	5.26 ± 1.40	5.41 ± 1.42	5.33 ± 1.46	0.622, 0.210, 0.491
NLR, mean ± SD	2.05 ± 1.21	1.96 ± 1.35	2.07 ± 1.31	1.91 ± 0.99	2.04 ± 1.21	2.02 ± 1.32	0.447, 0.158, 0.824
PLT count, mean ± SD, × 109/L	184.72 ± 44.67	142.52 ± 49.26	186.16 ± 44.28	142.94 ± 47.99	187.73 ± 43.49	147.90 ± 49.24	< 0.001, < 0.001, < 0.001
HBV DNA, mean ± SD, log IU/mL	6.35 ± 1.91	5.56 ± 1.59	6.44 ± 1.87	5.39 ± 1.64	6.47 ± 1.88	5.52 ± 1.67	< 0.001, < 0.001, < 0.001
APRI, mean ± SD	0.33 ± 0.14	0.59 ± 0.42	0.32 ± 0.13	0.58 ± 0.39	0.32 ± 0.12	0.54 ± 0.37	< 0.001, < 0.001, < 0.001
FIB-4, mean ± SD	1.01 0.53	1.81 ± 1.34	0.97 ± 0.49	1.81 ± 1.28	0.96 ± 0.49	1.67 ± 1.21	< 0.001, < 0.001, < 0.001
LIF-5, mean ± SD	0.37 ± 0.13	0.54 ± 0.17	0.36 ± 0.12	0.53 ± 0.16	0.36 ± 0.12	0.51 ± 0.16	< 0.001, < 0.001, < 0.001

Quantitative data of normal distribution were expressed as mean ± standard deviation, and categorical data were expressed as frequency and percentage. A: Liver inflammatory activity; AGR: Albumin–globulin ratio; ALB: Albumin; ALP: Alkaline phosphatase; ALT: Alanine aminotransferase; APRI: Aspartate transaminase to platelet ratio index, APRI = [(AST/ULN)/platelet counts (10⁹/L)] × 100[16]; AST: Aspartate aminotransferase; F: Fibrosis; FIB-4: Fibrosis-4, FIB-4 = [age (year) × AST (U/L)]/(platelet count (10⁹/L) × [ALT (U/L)^1/2][17]; GGT: Gamma-glutamyl transpeptidase; HBeAg: Hepatitis B e antigen; GLB, globulin; LIF-5: Liver inflammation and fibrosis-5, LIF-5 = 0.725 + 0.005 × age (year) + 0.003 × ALT (U/L) + 0.004 × AST (U/L) - 0.201 × (A/G) - 0.002 × PLT (10⁹/L)[18]; NLR: Neutrophils lymphocytes ratio; PLT: Platelets; WBC: White blood cell.