RESUMO
Background and Aim: The coexistence of metabolic-associated fatty liver disease (MAFLD) in the course of chronic hepatitis B virus infection increases liver-related morbidity. A positive correlation was found between positive hepatitis B core antibody (anti-HBc) and the risk of cirrhosis and hepatocellular carcinoma (HCC) in MAFLD. The relationship between anti-HBc positivity and MAFLD progression to fibrosis, cirrhosis, and liver-related outcomes was determined. Materials and Methods: This is a retrospective study including 242 patients with biopsy-proven MAFLD, 130 patients with clinically diagnosed MAFLD-related cirrhosis, and 62 patients with MAFLD-related or cryptogenic HCC. Anti-HBc antibody results were compared with clinical outcomes. Results: Anti-HBc positivity was associated with fibrosis severity (p=0.005). Anti-HBc was positive in 19 (20.2%), 33 (25.8%), 53 (35.3%), and 27 (43.5%) patients with F0-F1 fibrosis, F2-F3 fibrosis, cirrhosis (F4), and HCC, respectively. Median steatosis score was grade 3 in anti-HBc positive patients and grade 2 in negative patients (p=0.07). Anti-HBc positivity was not associated with significant fibrosis (≥F2), cirrhosis, and any liver related complications including HCC. Conclusion: Higher anti-HBc positivity was found in MAFLD patients with advanced fibrosis and cirrhosis compared to patients with early stage fibrosis. No relation was found between anti-HBc positivity and development of cirrhosis, HCC or other liver related complications.
RESUMO
Background and Aim: Erectile dysfunction (ED) is an important and commonly seen disorder in patients with non-alcoholic fatty liver disease (NAFLD). The objective of this study was to assess the rate of ED and its causes in a group of NAFLD patients. Materials and Methods: The International Index of Erectile Function questionnaire (IIEF-5) was used to evaluate the presence, causes, and severity of ED. Participants with an IIEF-5 score of <22 who agreed to undergo a urological evaluation were referred to a urologist for further assessment. Results: A total of 136 NAFLD patients were enrolled in the study. According to the IIEF-5, 68 (50.0%) patients had ED. Multivariate analysis indicated that older age, obesity, and hypertension were associated with ED. Seventeen patients had multiple etiological factors for ED. Psychogenic ED was identified in 19 patients (39.6%), vasculogenic ED in 35 patients (72.9%), drug-related ED in 3 patients (6.3%), and neurogenic ED in 6 patients (12.5%). Conclusion: ED is frequently seen in NAFLD patients, which may, at least in part, be due to common risk factors. Vasculogenic dysfunction is the most common single source of ED in NAFLD patients. Nonetheless, all potential etiologies should be carefully investigated, with special attention given to psychogenic factors, since they may be more frequent and relevant than expected.
