Association between hepatitis B virus infection and diabetes mellitus: A meta-analysis

Abstract

Abstract. Hepatitis B virus (HBV) infection has been shown by certain studies to be associated with diabetes mellitus (DM); however, the results of these studies were controversial. For that reason, a meta-analysis of the literature was performed in order to determine the association between HBV infection and the prevalence of DM more accurately. The PubMed, Embase, Chinese National Knowledge Infrastructure and Wan Fang databases, as well as the Chinese Science and Technology Journal Database, were searched for literature published until June 2014. The reference lists of all relevant articles were also searched. The summary odds ratios (ORs) and their corresponding 95% confidence intervals (95% CIs) were calculated based on a random-effects model. Heterogeneity was assessed using the I 2 statistic. Subgroup analyses were conducted based on study type and region for the purpose of assessing the factors that could potentially affect the outcome. A total of 15 eligible studies (in 14 articles) were selected for the meta-analysis, involving 12,974,690 HBV-infected patients and 231,776,232 controls. The OR for the prevalence of DM was 1.33 (95% CI, 1.09-1.62; P=0.005) between the patients with HBV infection and the controls. The subgroup analysis based on study type revealed a significantly higher prevalence of DM in the HBV-infected group than that in the control group in both case-control (OR, 1.89; 95% CI, 1.08-3.30; P=0.025) and cross-sectional (OR, 1.41; 95% CI, 1.04-1.90; P=0.027) studies. The subgroup analysis based on region revealed a significantly higher prevalence of DM in the HBV-infected group than in the control group in the Asia-Pacific region (OR, 1.67; 95% CI, 1.08-2.58; P=0.022). Compared with uninfected patients, the pooled results suggest that HBV-infected patients have a higher risk of developing DM; however, given the fact that this is a meta-analysis of observational studies, further randomized controlled trials are required in order to reach a more accurate conclusion.

Evaluation of Liver Enzyme Elevation and Its Contributing Factors in Birjand, Iran

“…The main reasons behind hepatocellular injury in FLD are elevated intracellular fatty acids, oxidative stress, and mitochondrial dysfunction. Another potential factor may be insulin-related disorders such as insulin resistance (25). In line with our findings, a study on 214 patients with FLD showed that 89% of them had a BMI of more than 25 (26).…”

“…Hyperinsulinemia promotes the replication of hepatitis B and C viruses. Moreover, diabetes mellitus suppresses the immune system, increases serum levels of free fatty acids, and increases the incidence and the severity of steatosis, steatohepatitis, and liver fibrosis (25).…”

Comparison of type 2 diabetes mellitus incidence in different phases of hepatitis B virus infection: A meta‐analysis

“…Cai et al. (2014) performed a meta‐analysis that indicated that patients with HBV infection were at a higher risk of developing DM when compared with patients without HBV infection . However, they did not correctly differentiate between the HBV infection phases for many of the original articles.…”

A Different Perspective for Management of Diabetes Mellitus: Controlling Viral Liver Diseases

“…In the Asia-Pacific area, the rate of DM in patients with HBV was higher than in patients uninfected with HBV [odds ratio (OR) 1.67] [16]. Hepatitis B surface (HBsAg) carriers had a three times higher rate (32.9%) of developing gestational diabetes compared with the regular population [17].…”