Association between Hepatitis B Virus Infection and Metabolic Syndrome in Southwest China: A Cross-sectional Study

Abstract

Hong tang 1 ✉ the correlation between hepatitis B virus (HBV) infection and metabolic syndrome (MetS) remains to be clarified. In this study, we explored this association in a large population in Southwest China. This was a cross-sectional study, with pooled adult health data. Multivariate logistic regression analysis, controlling for age, sex, HBV status, alanine aminotransferase, and fatty liver, was used to identify predictor(s) of MetS. Of the 96,175 participants, positive HBV was identified in 7984 (8.30%) and MetS in 12,092 (12.57%). The MetS prevalence was lower among HBV positive than negative individuals (11.64% versus 12.66%, P < 0.001). The adjusted odds (aOR) of positive HBV among individuals with MetS was 0.841 (95% confidence interval (CI), 0.771-0.916) in men and 0.834 (95% CI, 0.672-0.925) in women. Elevated triglyceride level, a component of MetS, was inversely associated with HBV status in both men and women: aOR, 0.551 (95% CI, 0.514-0.590) and 0.683 (95% CI, 0.605-0.769), respectively. Among HBV positive individuals, liver cirrhosis was more common among those with than without MetS (4.83% versus 2.93%, respectively; P = 0.002). HBsAg-seropositive are inversely associated with MetS, especially elevated triglycerides. Liver cirrhosis was more common among HBV infection patients with MetS. Chronic hepatitis B virus (HBV) infection is a major public health issue 1. HBV infection is not only the cause of acute and chronic hepatitis, but is also one of the key etiological factors of liver cirrhosis and hepatocellular carcinoma (HCC). In 2015, it was estimated that 257 million people, 3.5% of the world's population, were living with a chronic HBV infection 2. In China, a HBV-endemic region, the prevalence of HBV infection for population among individual 1 to 59 years of age is approximately 7.18%, with an estimated 93 million patients individuals in China living with a chronic HBV infection 3. Although the health morbidities of chronic HBV infection are decreasing, these remain a tremendous healthcare burden in China. Considering that the liver plays a key role in glucose homeostasis and lipid metabolism, the possible association between liver disease and diabetes mellitus or metabolic syndrome (MetS) has been a topic of healthcare research interest. MetS refers to diseases caused by metabolic disturbances, such as increased waist circumference, hyperglycemia, elevated blood pressure (BP), and dyslipidemia. MetS affects approximately one-fifth in China, reflecting the increasing prevalence of obesity 4,5. MetS is characterized by dyslipidemia and glucose metabolism disorders, both of which are influenced by hepatic function. In fact, an association between MetS and non-alcoholic fatty liver disease (NAFLD), chronic hepatitis C (CHC) and HCC has previously been demonstrated 6,7. Additionally, NAFLD is considered as the hepatic manifestation of MetS 8. It is also now widely confirmed that chronic hepatitis C virus infection may increase the risk of insulin resistance and type 2 diabetes 9. MetS is als...

Association of hepatitis B virus infection and allergy with the risk of gastrointestinal cancer

“…Therefore, patients in this region choose hospitals in Kunming, the administrative center, as far as possible. The HBsAg positivity of 50,871 patients in this study is 3.3%, a value lower than other reports, which can represent the general situation of HBV infections in Southwest China [14,15].…”

“…Compared to the HBsAg-negative cancer patients, the median ages at diagnosis and death are signi cantly younger for the HBsAg-seropositive cancer patients [11,12] .In China, HBV infection is one of the three most common infectious diseases, according to the Ministry of Health. It is an endemic epidemic, with a prevalence ranging between 4.38-8.30%, which shows a certain local variation [13][14][15]. Moreover, statistical heterogeneity exists in some case-control studies concerning HBV and extrahepatic tumors due to insu cient matching variables, time of diagnosis, age and gender mismatches [7,16].…”

Metabolic Disorders in Patients with Chronic Hepatitis B Virus Infection: Coffee as a Panacea? (ANRS CO22 Hepather Cohort)

“…In terms of HBV-infected patients, a population prone to liver cancer, this possible lipid-raising effect is of particular interest. HBV infection is associated with lower levels of serum total cholesterol, HDL cholesterol, and TG [ 1 , 2 ]. Furthermore, lower serum cholesterol is associated with more advanced stages of liver disease in this population [ 9 , 59 ], while higher serum cholesterol is associated with better liver cancer survival [ 10 ].…”

“…Hepatitis B virus (HBV) infection affects hosts’ metabolic pathways. It is associated with lower levels of serum total cholesterol, high-density lipoprotein (HDL) cholesterol, and triglycerides (TG) [ 1 , 2 ]. Metabolic syndrome (MetS) is defined as having three or more of the following cardiovascular risk factors: central obesity, elevated TG, reduced HDL-cholesterol, elevated blood pressure, and elevated fasting glucose [ 3 ].…”

Μελέτη Της HBV Λοίμωξης Και Αναζωπύρωσης Σε Ασθενείς Με Ρευματικές Παθήσεις Υπό Ανοσοκατασταλτική Αγωγή

“…Για αυτήν απαιτείται η σειριακή καταγραφή και παρακολούθηση του HBeAg, των επιπέδων του HBV DNA και της ALT, αλλά ακόμη και με τη χρήση αυτών θα υπάρξουν ασθενείς που ο κλινικός ιατρός θα δυσκολευτεί να κατατάξει με ακρίβεια. Σε αυτούς τους ασθενείς η θεραπεία και αντιμετώπιση της ηπατίτιδάς τους θα πρέπει να εξατομικεύεται.Επιπλέον, εκτός από τους παραπάνω παράγοντες, υπάρχουν και άλλες παράμετροι που παίζουν σημαντικό ρόλο στην πρόγνωση της ηπατίτιδας Β. Τέτοιοι δυσμενείς προγνωστικοί παράγοντες41,42 είναι το φύλο, η κατανάλωση αλκοόλ και καπνού, η παχυσαρκία43,44 , ο σακχαρώδης διαβήτης και η λοίμωξη από άλλους ηπατοτρόπους ιούς45 . Η χρήση ανοσοκατασταλτικών θεραπειών επίσης έχει συσχετισθεί με την αντίστροφη ορομετατροπή τόσο του anti-HBe σε HBeAg46 όσο και με την επανενεργοποίηση της ηπατίτιδας (επανεμφάνιση ιικού φορτίου στον ορό), όπως θα περιγραφεί εκτενώς στη συνέχεια.Η φυσική ιστορία της χρόνιας ηπατίτιδας Β πλέον διακρίνεται σε πέντε φάσεις (σχήμα 4), αν και δεν περνούν όλοι οι ασθενείς απαραίτητα από όλες αυτές.…”