Distribution of alanine transarninase in male subjects with ultrasonography diagnostic fatty liver and positive serum HBsAg

Objective To investigate the clinical characteristics of serum HBsAg positive subjects with ultrasonography diagnostic fatty liver(SFL).Methods Gender,age,height,body weight,blood pressure,fasting biochemical criterions,serum HBV markers,and abdominal sonographic evaluation data in all subjects(aged 18-70,without severe diseases) from June to September 2006 were collected and analyzed.Results Prevalence of HBsAg positive SFL(HBsAg+/ SFL+) was 2.24%(100/4 469),and the occurrence rate of SFL was lower in HBsAg carriers(n = 547) than that in subjects without HBsAg(n = 3 922)(18.3% vs 24.0%,P = 0.003).Proportions of subjects with age 35,body mass index 25,elevated plasma glucose,elevated cholesterol and elevated alanine transarninase(ALT)( 40 IU/L) in HBsAg positive SFL group(HBsAg+/ SFL+ group,n = 94) were similar to those in HBsAg negative SFL group(HBsAg-/ SFL+ group,n = 837),but those in the both groups were significantly higher than those in no SFL groups(HBsAg+/ SFL-group,n = 318 and HBsAg-/ SFL-group,n = 1 975).Subjects in HBsAg+/ SFL+ group had a higher risk having ALT 60 IU/L(OR = 6.381,95% CI = 3.619-11.250,P 0.001) as compared to HBsAg-/ SFL+ group(OR = 4.395,95% CI = 3.127-6.178,P 0.001) or HBsAg+/ SFL-group(OR = 4.453,95% CI = 2.921-6.787,P 0.001).In subjects with normal ALT(≤40 IU/L) levels,proportion of subjects with actual ALT 20 IU/L was significantly higher in HBsAg+/ SFL+ group(44/51) than those in HBsAg-/ SFL+ group(356/487,P=0.043),HBsAg+/ SFL-group(157/223,P = 0.022) and HBsAg-/ SFL-group(844/1 751,P 0.001).Conclusions The clinical characteristics of male HBsAg carriers with SFL were different from those with ordinary HBV infection,but were similar to SFL patients without HBsAg.The probability of exacerbation is increased in HBsAg carriers with SFL than that in SFL patients without HBsAg.