韓国の保険加入者ベースのB型慢性肝炎患者コホートにおける併存疾患の増加

Increasing comorbidities in a South Korea insured population-based cohort of patients with chronic hepatitis B.

• Hyunwoo Oh
• Dae Won Jun
• I-Heng Lee
• Hyun Jung Ahn
• Bo Ok Kim
• Sungeun Jung
• Mindie H Nguyen

抄録

背景:

B型慢性肝炎（CHB）患者が非CHB対象者よりも肝臓以外の合併症が多いかどうかは議論の余地がある。

BACKGROUND: It is controversial whether chronic hepatitis B (CHB) patients have more non-liver comorbidities than non-CHB subjects.

エイム:

韓国のCHB患者の人口統計学、併存疾患、健康利用の特徴を明らかにし、対照群と比較する。

AIM: To characterise the demographics, comorbidity and health utilisation of CHB patients in South Korea and compare them to matched controls.

方法:

METHODS: Using the Health Insurance Review & Assessment Service (HIRA) 2007-2016 database, adult patients with claims for CHB analysed. CHB cases and non-CHB controls matched in a 1:4 ratio using propensity score matching method.

結果:

CHB患者の年齢は、2007年の平均46.9歳から2016年には52.3歳へと有意に上昇した。肝臓に関連する疾患と肝臓に関連しない疾患の両方を持つ人の割合は、CHB患者では対照群と比較して高かった（脂質異常症[37.23% vs 23. 77%]）。77％、P<0.0001］、高血圧［29.39％対25.27％、P<0.0001］、慢性腎臓病（CKD）［3.02％対1.14％、P<0.0001］、骨粗鬆症・骨折［OF］［4.09％対3.23％、P<0.0001］）。CHB患者の約50％がCKD、糖尿病、DLP、OFのうち1つ以上の併存疾患を有していた。CHB患者のCKDのオッズは1.42倍、交絡因子を調整した後のCHB患者のOFのオッズは、マッチドコントロールと比較して1.09倍高かった（P<0.0001）。

RESULTS: The age of CHB patients significantly increased from a mean 46.9 years in 2007 to 52.3 years in 2016. The proportions of persons having both liver-related and non-liver related comorbidities were higher in CHB patients compared to matched controls (dyslipidaemia [37.23% vs 23.77%, P < 0.0001], hypertension [29.39% vs 25.27%, P < 0.0001] chronic kidney disease (CKD) [3.02% vs 1.14%, P < 0.0001] and osteoporosis/fracture [OF] [4.09% vs 3.23%, P < 0.0001]). Approximately 50% of CHB patients had more than one comorbidity among CKD, diabetes, DLP, and OF. The odds of CKD in CHB patients were 1.42 times higher, and the odds of OF in CHB patients were 1.09 times higher than matched controls after adjustment for confounders (P < 0.0001).

結論:

CHB患者の肝臓と肝臓以外の合併症の有病率は、対照群と比較して高く、時間の経過とともに増加していた。

CONCLUSION: Prevalence of liver as well as non-liver comorbidities in patients with CHB was higher than matched controls and increased over time.

© 2020 John Wiley & Sons Ltd.