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目的:探讨金昌队列人群HBV感染对脂肪肝患病的影响，为脂肪肝的防治提供理论依据。方法:以金昌队列基线人群为研究对象，开展流行病学调查、实验室检查和腹部B超检查，描述并比较不同HBV感染模式下的脂肪肝患病率异同，采用logistic回归分析不同HBV感染模式对脂肪肝患病的影响。结果:金昌队列基线人群共45 605人，男性27 917人，女性17 688人，男女性比例1.6∶1；总人群年龄均值为46.49岁。队列人群常见8种HBV感染模式中以大三阳（HBsAg、HBeAg和HBcAb阳性）、小二阳（HBsAg和HBcAb阳性）和小三阳（HBsAg、HBeAb和HBcAb阳性）3种模式的脂肪肝患病率较低。HBsAg和HBeAg阳性组脂肪肝患病率低于HBsAg和HBeAg阴性组。logistic回归分析结果显示，小二阳（n OR=0.61，95%n CI：0.39~0.98）和大三阳（n OR=0.52，95%n CI：0.30~0.89）是脂肪肝患病的保护因素。n 结论:急性HBV感染可降低脂肪肝的患病率，原因可能与活跃的HBV复制干扰机体脂肪代谢有关。“,”Objective:To investigate the influence of HBV infection on the prevalence of fatty liver disease in Jinchang cohort and provide theoretical evidence for the prevention and treatment of fatty liver disease.Methods:Epidemiological investigation, laboratory examination and abdominal ultrasound were conducted in the baseline population of Jinchang cohort to collect the basic data, the differences in the prevalence of fatty liver disease under different HBV infection patterns were described and compared and the influence of different HBV infection patterns on the prevalence of fatty liver disease were evaluated by using logistic regression analysis.Results:The baseline Jinchang cohort population totaled 45 605, including 27 917 males and 17 688 females. The male to female ratio was 1.6∶1. The mean age of the overall population was 46.49 years. Among the 8 common HBV infection modes in the Jinchang cohort, the prevalence of fatty liver was low in HBsAg, HBeAg and HBcAb positive, HBsAg and HBcAb positive, and HBsAg, HBeAb and HBcAb positive groups. For 4 serum markers of HBV infection, the prevalence of fatty liver disease in HBsAg and HBeAg positive groups was lower than that in HBsAg and HBeAg negative groups. Logistic regression analysis showed that being HBsAg and HBcAb positive (n OR=0.61, 95%n CI: 0.39-0.98) and HBsAg, HBeAg and HBcAb positive (n OR=0.52, 95%n CI: 0.30-0.89) could reduce the risk for fatty liver disease.n Conclusion:Acute HBV infection reduces the prevalence of fatty liver disease, and the reason may be related to the disturbance of the body's fat metabolism by active HBV replication.