Non-ALT biomarkers for markedly abnormal liver histology among Chinese persistently normal alanine aminotransferase-chronic hepatitis B patients

doi:10.3748/wjg.v23.i15.2802

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World Journal of Gastroenterology

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World J Gastroenterol. Apr 21, 2017; 23(15): 2802-2810
Published online Apr 21, 2017. doi: 10.3748/wjg.v23.i15.2802

Table 1 Baseline demographic and clinical characteristics of all subjects with normal alanine aminotransferase level

	All (n = 155)	HBeAg-positive (n = 86)	HBeAg-negative (n = 69)
Age (yr)	39.7 ± 9.9	42.9 ± 8.9	37.2 ± 9.9
Male, n (%)	84 (54.2)	52 (60.9)	34 (48.8)
HBV DNA (logIU/mL)	5.8 ± 2.1	4.3 ± 1.4	6.9 ± 1.9
WBC (10⁹/mL)	5.9 ± 3.1	5.9 ± 4.4	5.8 ± 1.5
PLT (10⁹/mL)	190.08 ± 62.9	182.29 ± 57.7	196.3 ± 66.5
ALT (U/L)	26.0 ± 8.7	25.0 ± 9.2	26.8 ± 8.1
AST (U/L)	24.6 ± 6.6	24.1 ± 6.1	25.1 ± 7.0
ALP (U/L)	68.1 ± 20.1	67.1 ± 17.2	68.9 ± 22.2
GGT (U/L)	21.8 ± 14.6	21.1 ± 11.9	22.3 ± 16.5
TB (g/L)	13.6 ± 6.7	13.6 ± 7.5	13.6 ± 6.1
PT (s)	11.4 ± 1.1	11.4 ± 1.0	11.4 ± 1.4
TT (s)	19.1 ± 1.7	18.8 ± 1.8	19.3 ± 1.5
A/G ratio	1.7 ± 0.4	1.8 ± 0.4	1.7 ± 0.4
Cr (μmol/L)	70.2 ± 14.6	70.0 ± 15.2	70.4 ± 14.2
TBA (μmol/L)	8.7 ± 14.1	6.3 ± 6.0	10.7 ± 17.9
GLB (g/L)	27.2 ± 4.3	26.9 ± 4.1	27.5 ± 4.4
ALB (g/L)	45.6 ± 4.0	46.7 ± 4.0	44.5 ± 3.9

A/G ratio: Albumin to globulin (A/G) ratio; ALB: Albumin; ALP: Alkaline phosphatase; ALT: Alanine aminotransferase; AST: Aspartate transaminase; Cr: Creatinine; GGT: Gamma-glutamyl transpeptidase; GLB: Globulin; PT: Prothrombin time; TB: Total bilirubin; TBA: Total bile acid; TT: Thrombin time.

Table 2 Demographic and clinical characteristics of carriers with and without significant liver changes

	Significant necroinflammation (n = 42)	No significant necroinflammation (n = 113)	P value	Significant fibrosis (n = 24)	No significant fibrosis (n = 131)	P value
Age (yr)	40.0 ± 9.3	39.7 ± 10.1	0.854	41.3 ± 10.3	39.5 ± 9.8	0.416
Male, n (%)	13	79	0.417	20	23	0.505
HBV DNA (logIU/mL)	6.0 ± 2.0	5.7 ± 2.2	0.368	5.6 ± 2.0	5.8 ± 2.1	0.733
WBC (10⁹/mL)	6.2 ± 5.7	5.7 ± 1.4	0.560	4.9 ± 1.2	6.0 ± 3.3	0.117
PLT (10⁹/mL)	170.2 ± 58.4	197.5 ± 63.2	0.016	150.3 ± 51.1	197.4 ± 62.3	0.001
ALT (U/L)	29.6 ± 8.8	24.6 ± 8.3	0.001	29.7 ± 8.0	25.3 ± 8.6	0.116
AST (U/L)	27.5 ± 6.0	23.6 ± 6.0	0.004	27.8 ± 6.4	24.1 ± 6.6	0.012
ALP (U/L)	70.4 ± 25.0	67.2 ± 17.9	0.463	78.7 ± 29.4	66.1 ± 17.3	0.004
GGT (U/L)	25.8 ± 19.4	20.3 ± 12.1	0.423	33.9 ± 25.4	19.6 ± 10.3	0.000
TB (g/L)	14.1 ± 6.9	13.4 ± 6.7	0.538	16.0 ± 7.2	13.2 ± 6.6	0.057
PT (s)	11.6 ± 1.0	11.3 ± 1.2	0.100	11.7 ± 1.0	11.3 ± 1.2	0.152
TT (s)	19.4 ± 1.7	19.0 ± 1.6	0.235	19.2 ± 1.8	19.1 ± 1.6	0.776
A/G ratio	1.8 ± 0.4	1.7 ± 0.4	0.173	1.7 ± 0.3	1.8 ± 0.4	0.700
Cr (μmol/L)	66.7 ± 14.6	71.5 ± 14.4	0.070	71.8 ± 14.2	69.9 ± 14.7	0.557
TBA (μmol/L)	9.0 ± 8.1	8.7 ± 15.7	0.900	16.8 ± 30.5	7.3 ± 7.4	0.002
GLB (g/L)	26.5 ± 4.3	27.5 ± 4.2	0.183	27.3 ± 3.9	27.2 ± 4.3	0.915
ALB (g/L)	45.1 ± 3.4	45.8 ± 4.2	0.335	44.2 ± 3.5	45.9 ± 4.1	0.058

Table 3 Univariate and multivariate logistic regression analysis of risk factors of significant necroinflammation and fibrosis

	Significant necroinflammation				Significant fibrosis
	Univariate		Multivariate		Univariate		Multivariate
	OR (95%CI)	P value	OR (95%CI)	P value	OR (95%CI)	P value	OR (95%CI)	P value
Age (yr)	0.994 (0.949, 1.042)	0.812			1.003 (0.968, 1.040)	0.120
Male	1.351 (0.530, 3.440)	0.529			1.346 (0.656, 2.760)	0.418
HBV-DNA (logIU/mL)	1.249 (0.978, 1.595)	0.075			1.078 (0.910, 1.276)	0.385
WBC (10⁹/mL)	0.907 (0.648, 1.269)	0.569			0.611 (0.359, 1.039)	0.069
PLT (10⁹/mL)	0.990 (0.980, 0.999)	0.03			0.692 (0.646, 0.709)	0.003	0.688 (0.641, 0.723)	0.008
ALT (U/L)	1.081 (1.020, 1.147)	0.009			1.059 (0.985,1.139)	0.121
AST (U/L)	1.590 (1.502, 1.651)	0.0002	1.682 (1.613, 1.704)	0.007	1.091 (1.006, 1.185)	0.036
ALP (U/L)	1.018 (0.994, 1.042)	0.139			1.051 (1.015, 1.089)	0.006
GGT (U/L)	1.021 (0.993, 1.050)	0.151			1.524 (1.491, 1.587)	0.007	1.453 (1.406, 1.511)	0.036
TB (g/L)	0.988 (0.921, 1.059)	0.723			1.025 (0.945, 1.112)	0.547
PT (s)	1.683 (0.941, 3.009)	0.079			2.022 (1.012, 4.042)	0.083
TT (s)	1.235 (0.945, 1.615)	0.122			1.294 (0.948, 1.768)	0.105
A/G ratio	2.053 (0.570, 7.393)	0.271			0.580 (0.099, 3.394)	0.546
Cr (μmol/L)	0.974 (0.941, 1.009)	0.143			1.000 (0.957, 1.046)	0.997
TBA (μmol/L)	1.063 (0.998, 1.131)	0.057			1.065 (1.001, 1.133)	0.048
GLB (g/L)	0.953 (0.862, 1.053)	0.345			1.001 (0.877, 1.143)	0.986
ALB (g/L)	0.931 (0.836, 1.036)	0.191			0.923 (0.805, 1.058)	0.250

Citation: Cheng JL, Wang XL, Yang SG, Zhao H, Wu JJ, Li LJ. Non-ALT biomarkers for markedly abnormal liver histology among Chinese persistently normal alanine aminotransferase-chronic hepatitis B patients. World J Gastroenterol 2017; 23(15): 2802-2810
URL: https://www.wjgnet.com/1007-9327/full/v23/i15/2802.htm
DOI: https://dx.doi.org/10.3748/wjg.v23.i15.2802