Association between chronic viral hepatitis and metabolic syndrome in southern Taiwan: a large population‐based study

Abstract

Summary Background The impact of metabolic syndrome (MetS) on hepatitis is an interesting issue. Aim To evaluate the association of MetS and chronic viral hepatitis including hepatitis B virus (HBV) and hepatitis C virus (HCV) infection in southern Taiwan. Methods From 2004 to 2013, a series of community‐based health screenings for residents aged 40 and older were held in Tainan city. MetS was defined according to the Joint Scientific Statement. Cut‐offs of body‐mass index measures of 24 kg/m2 and 27 kg/m2 were used to stratify lean, overweight and obese subjects. Results We enrolled 180 359 participants; the prevalence of MetS was 30.1%, which was significantly associated with advanced age and female sex. There were 18 726 (10.4%) HBV, 13 428 (7.4%) HCV, 1337 (0.7%) HBV plus HCV (B+C) and 146 868 (81.5%) non‐HBV non‐HCV participants (NBNC). Prevalence rates of MetS in subjects with HBV, HCV, B+C and NBNC were 25.2%, 31.5%, 28.9% and 30.7% respectively (P < 0.001). There were 18.8% lean body, 35.4% overweight and 45.8% obese participants among 54 361 MetS subjects. Lean MetS subjects were older, had more diabetes, and had higher metabolic component levels, but lower alanine transaminase and aspartate transaminase‐platelet ratio index levels compared with obese MetS subjects. HCV infection was positively associated with MetS (P < 0.001). However, HBV infection was inversely associated with MetS only among lean subjects (P = 0.002), but not among the general population. Conclusions This large population‐based study indicated that HCV infection was positively associated with MetS. However, HBV infection was inversely associated with MetS only among lean subjects.

Editorial: hepatitis B, fatty liver, and metabolic syndrome—interaction or co‐existence?

“…In a recent issue, Kuo et al added to our current knowledge with their study on 180 359 patients from Taiwan. Unlike the meta‐analysis of Razi et al, they did not demonstrate a negative association between CHB infection and MetS . In this large population study from south Taiwan, the prevalence of MetS was 25.2% and 30.7% in the CHB and non‐CHB cohorts, respectively.…”

Systematic review: chronic viral hepatitis and metabolic derangement

“…These two diseases have overlapping manifestations and close association. The prevalence of MetS ranges from 13.2% to 31.5% among HCV‐infected patients and is higher in older subjects . HCV‐infected African Americans seem to be more prone to developing MetS than other ethnicities .…”

“…Insulin resistance or metabolic derangement of glucose is the central pathogenesis of both chronic hepatitis C (CHC) and MetS. HCV infection was strongly associated with MetS in a large population cohort study . These two diseases have overlapping manifestations and close association.…”

“…A recent large population‐based study identified an association between chronic viral hepatitis and MetS in southern Taiwan. They found that HCV was positively associated with MetS, but HBV infection was inversely associated with MetS only for lean subjects (BMI below 24 kg/m 2 ) …”

“…They found that HCV was positively associated with MetS, but HBV infection was inversely associated with MetS only for lean subjects (BMI below 24 kg/m 2 ). 43 Three reviews and a meta-analysis have been published in the last 3 years. The first review found that an odds ratio of MetS risk in chronic HBV-infected patients is 0.82, but it was not statistically significant.…”