Clarke WT, et al. - In this tertiary care, single-center retrospective cohort study of 617 chronic HBV (CHB) patients, researchers sought to determine the relationship between CHB, metabolic syndrome (MS) and steatosis as well as the prevalence of the latter two. Among these patients (male: 57%; mean age: 53 years; Asian:88%), receipt of HBV therapy was reported in 64% and undetectable DNA was reported in 65%. MS was reported in 21%; hypertension (41%), dyslipidemia (41%) and obesity (32%) were the most commonly seen. MS was reported in more frequently older (60 vs 52) patients; in addition, these cases more frequently had steatosis (40 vs 17%) and had a higher ALT (29 vs 25). Steatosis by ultrasound was reported in 22% of patients; a higher prevalence of MS (38 vs 16%) and higher ALT (31 vs 24) was seen in these patients. Findings suggest that MS, steatosis and elevated ALT in HBV patients are strongly correlated. Despite lower BMI compared to non-Asians, Asian HBV patients showed the same prevalence of steatosis and other MS risk factors, supporting guidelines for lower BMI targets in Asians.