A population-based study investigating the association between metabolic syndrome and Hepatitis B/C infection (Keelung Community-based Integrated Screening Study No. 10)

Abstract

Objectives: We aimed to assess the association between metabolic syndrome (MS) and hepatitis B/C virus infection using a large population-based study. Design and methods: A population-based cross-sectional study design was adopted with a total of 53 528 subjects being enrolled from the integrated multiple diseases screening program in Keelung, Taiwan. Evidence of past hepatitis B/C infection, acquired during childhood or as a young adult, was identified during the two-stage liver cancer screening part of the process. Information on biochemical markers and anthropometric measures related to MS, such as fasting blood sugar, triglyceride and high-density lipoprotein (HDL), abdominal circumference and blood pressure (BP), were collected routinely while screening for hypertension, type 2 diabetes, and hyperlipidemia. Logistic regression was used to estimate odds ratios and related 95% confidence intervals for the associations between MS and hepatitis B/C infection. Results: High blood pressure (SBPX135 mmHg or DBPX85 mmHg) (adjusted odd ratio: 0.89 (0.83-0.94)) and high triglyceride (X150 mg/dl) (adjusted odds ratio: 0.65 (0.60-0.69)) were, after adjusting for gender and age, inversely associated with being HBsAg positive (Po0.05). The likelihood of developing MS was lower in the HBsAg positive than the HBsAg negative (adjusted odds ratio: 0.84 (0.76-0.93)). A positive association between being anti-HCV positive and having low serum HDL (male o40 mg/dl, female o50 mg/dl) was also noted (adjusted odds ratio: 1.61 (1.37-1.88) after controlling for gender and age). High triglyceride was inversely associated with being anti-HCV positive (adjusted odds ratio: 0.63 (0.55-0.71). Conclusions: There is an inverse association between MS and hepatitis B virus infection whereas the association was heterogeneous for HCV infection with a positive association with abnormal serum HDL but an inverse association with hypertriglyceridemia.

Metabolic profiles in patients with chronic hepatitis C: a case–control study

“…In this study, we consistently showed HCV infection was associated with a lower TG level [18]. In the transgenic mouse model, HCV core protein appears to interfere with the hepatic assembly and secretion of ApoB containing very low-density lipoproteins (VLDL) [41].…”

“…Recently, a population-based study revealed a positive association between HCV infection and hyperglycemia [18], but the association disappeared when adjusted for age and gender. However, our analyses demonstrated that more chronic hepatitis C patients had an impaired fasting glucose compared to sex-and age-matched controls (data not shown).…”

“…The inconsistencies may be due to small sample size, the selection of patients only from hospitals or limited to hepatitis patients with cirrhosis, with diabetes, or to post-liver-transplant. Although large population-based studies have been performed [17][18][19], the results still lack consistency and are limited to some metabolic factors.…”

Obesity and hepatitis B infection are associated with increased risk of metabolic syndrome in university freshmen

“…19 Jan et al 19 have found that, after adjusting for age and gender, those who are HBsAg( þ ) have lower risk (OR ¼ 0.84, Po0.05) for concomitant metabolic syndrome than those who are HBsAg(À). In that study, the criterion to define metabolic syndrome is different and some potential confounders such as BMI and smoking are not adequately adjusted.…”

“…Furthermore, the relationship between the status of hepatitis B immunity and metabolic syndrome remains unclear although chronic hepatitis B infection has been reported to associate with metabolic syndrome. 19 In Taiwan, the universal hepatitis B vaccination program has been initiated for children since 1986. Thus, the goal of our cross-sectional study is to assess the prevalence of overweight, obesity and metabolic syndrome in a cohort of university freshmen in Taiwan.…”