Cardiometabolic index and central adiposity as non-invasive markers of hepatic steatosis and elevated liver stiffness in chronic hepatitis B

Abstract

Background and Aim: Residual liver disease in chronic hepatitis B (CHB) under long-term antiviral therapy is increasingly metabolic. We assessed whether the cardiometabolic in-dex (CMI), modified CMI (MCMI) and simple anthropometry are associated with hepatic steatosis and elevated liver stiffness. Materials and Methods: In a two-part cross-sectional study, CMI and MCMI were com-pared between inactive hepatitis B virus carriers (n=21) and matched controls (n=27). Separately, 92 nucleos(t)ide-treated CHB patients underwent vibration-controlled tran-sient elastography (VCTE). Significant steatosis was a controlled attenuation parameter (CAP) ≥268 dB/m and elevated liver stiffness a liver stiffness measurement ≥7.0 kPa. No biopsy was performed. Areas under the curve (AUC) were compared by the DeLong test, and cutoff performance was internally validated by bootstrap. Results: CMI and MCMI did not differ between carriers and controls (p>0.6). Significant steatosis occurred in 44 of 91 (48%) and elevated liver stiffness in 48 of 90 (53%). CMI correlated with CAP (rho=0.37, p