AUTHOR=Yang Qiao , Tong Yifan , Pi Borui , Yu Hong , Lv Fangfang 

TITLE=Influence of Metabolic Risk Factors on the Risk of Bacterial Infections in Hepatitis B-Related Cirrhosis: A 10-Year Cohort Study

JOURNAL=Frontiers in Medicine

VOLUME=Volume 9 - 2022

YEAR=2022

URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2022.847091

DOI=10.3389/fmed.2022.847091

ISSN=2296-858X

ABSTRACT=Aims: The effect of metabolic factors on bacterial infections (BIs) in hepatitis B virus (HBV)-related cirrhosis has not been demonstrated. This study aimed to figure out metabolic factors predicting incidence of BIs in these patients. 
Methods: A population-based cohort of 471 cirrhotic patients with HBV infections were retrospectively enrolled between 2009 and 2019. The primary end point was the incidence of BIs during hospitalization，which were compared according to the metabolism-related indicators namely presence of diabetes, level of high density lipoprotein cholesterol (HDLC) and triglyceride, and body mass index (BMI). The propensity score matching (PSM) were adopted to eliminate baseline discrepancies. 
Results: Compared with non-diabetes group, the incidences of BIs were higher in the diabetes group before and after PSM (p=0.029 and p=0.027). Similar results were found in the low HDLC group as compared to the normal HDLC group before and after PSM (p<0.001 and p=0.025). Further investigations indicated that the incidences of BIs in patients with low HDLC alone were lower than patients with both low HDLC and diabetes before and after PSM (p=0.003 and p=0.022). Similarly, the incidence of BIs in patients with diabetes alone was lower than those in patients with both low HDLC and diabetes both before and after PSM (p=0.002 and p=0.018). However, neither triglyceride nor BMI had relationship with BIs in our cohort. 
Conclusion: In patients with HBV-related cirrhosis, the presence of diabetes and low level of HDLC were identified as risk factors for BIs, and showed the synergistic effects on BIs. (249 words)