HBsAg Carrier Status and the Association Between Gestational Diabetes With Increased Serum Ferritin Concentration in Chinese Women

Lao, Terence T.; Tse, Ka Yu; Chan, Louis Yik-Si; Tam, Kwok-kan; Ho, Lai Fong

doi:10.2337/diacare.26.11.3011

Cited by 72 publications

(98 citation statements)

References 36 publications

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“…Nevertheless, there is indirect evidence suggesting that chronic HBV infection may increase the risk of chronic inflammation and insulin resistance, which then interact with other factors to influence the clinical course of type 2 diabetes. In a study involving 767 pregnant Chinese women in Hong Kong, HBsAg carrier status was associated with a 3.5-fold increased risk of gestational diabetes [15]. The HbsAgpositive women with gestational diabetes had higher serum ferritin levels than the HbsAg-negative women.…”

Section: Discussionmentioning

confidence: 98%

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Chronic hepatitis B viral infection independently predicts renal outcome in type 2 diabetic patients

et al. 2006

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Aims/hypothesis: We examined the association between chronic hepatitis B virus (HBV) infection and clinical outcomes in a consecutive cohort of Chinese patients with type 2 diabetes. Subjects, materials and methods: Between 1995 and 1999, 2,838 type 2 diabetes patients underwent comprehensive assessments and blood screening for hepatitis B surface antigen (HBsAg). The risk of occurrence of cardiovascular events and end-stage renal disease (defined as need for dialysis, doubling of serum creatinine or serum creatinine ≥500 μmol/l) was compared between HBsAg-positive and HBsAg-negative groups. Results: At baseline, HBV-infected patients (n=286, 10.1%) were younger (51.0±11.5 vs 53.7±12.7 years, p=0.004), had earlier onset of diabetes (51.0±11.5 vs 53.7±12.7 years, p=0.001) and a higher frequency of retinopathy (28 vs 22%, p=0.03) than non-HBV-infected patients. After a median follow-up of 3.5 years (interquartile range: 1.7-5.9 years) and adjustment of age, glycaemic control and other potential confounding factors, HBV-infected patients were more likely to develop end-stage renal disease than non-HBV infected patients (8.7 vs 6.4%) with a hazard ratio of 4.5 (95% CI 1.1-18.6). The difference in the frequency of cardiovascular endpoints was not statistically significant. Conclusions: In Chinese type 2 diabetes patients, chronic HBV infection was associated with increased risk of end-stage renal disease, and this was independent of other potential confounding factors. Early identification of HBV status and close surveillance of renal function are important in patients with type 2 diabetes who are living in areas where HBV is endemic or who are at risk of chronic HBV infection.

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Section: Discussionmentioning

confidence: 98%

“…In a retrospective study of 767 pregnant Chinese women, chronic HBV infection was associated with a 3.5-fold increased risk of gestational diabetes [15]. Women with chronic HBV infection also had higher plasma glucose levels than those who were uninfected at their first antenatal visit.…”

Section: Introductionmentioning

confidence: 99%

Chronic hepatitis B viral infection independently predicts renal outcome in type 2 diabetic patients

et al. 2006

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“…5 In addition, the results from previous studies investigating the relationship between hepatitis B infection and type 2 diabetes are inconsistent. Three studies reported a positive association between the two, [6][7][8] two found no association, 9,10 and one found an inverse association. 11 Inconsistent results have also been reported about the association between hepatitis C infection and type 2 diabetes.…”

Section: Introductionmentioning

confidence: 98%

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

et al. 2006

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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.

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“…A study on Chinese pregnant women found that HBsAg carriage was a risk factor for gestational diabetes (19). Mean serum ferritin concentration has also been found to be higher among ethnic Chinese than other ethnic groups in Singapore (20).…”

Section: Limitation Of the Studymentioning

confidence: 99%

Association Between Serum Ferritin, Hemoglobin, Iron Intake, and Diabetes in Adults in Jiangsu, China

Shi

Bao

et al. 2006

Diabetes Care

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OBJECTIVE -To investigate the association between iron status, iron intake, and diabetes among Chinese adults.RESEARCH DESIGN AND METHODS -This cross-sectional household survey was carried out in 2002 in Jiangsu Province, China. The sample contained 2,849 men and women aged Ն20 years with a response rate of 89.0%. Iron intake was assessed by food weighing plus consecutive individual 3-day food records. Fasting plasma glucose (FPG), serum ferritin, and hemoglobin were measured.RESULTS -The prevalence of anemia was 18.3% in men and 31.5% in women. Mean hemoglobin and serum ferritin increased across groups with increasing FPG. The prevalence of anemia among women was 15.0% in individuals with FPG Ͼ7.0 mmol/l compared with 32.6% in individuals with FPG Ͻ5.6 mmol/l. There was a similar, however not significant, trend among men. In women, after adjusting for known risk factors, the odds ratio (OR) of diabetes was 2.15 (95% CI 1.03-4.51) for subjects in the upper quartile of hemoglobin compared with the rest, and the corresponding OR for the upper quartile of serum ferritin was 3.79 (1.72-8.36). Iron intake was positively associated with diabetes in women; fourth quartile intake of iron yielded an OR of 5.53 (1.47-20.44) compared with the first quartile in the multivariate analyses. In men, similar trends were suggested, although they were not statistically significant.CONCLUSIONS -Iron status and iron intake was independently associated with risk of diabetes in Chinese women but not in men. Diabetes Care 29:1878 -1883, 2006T here is an increasing concern about the relationship between iron status and type 2 diabetes (1-6). Excessive body iron is found to be associated with diabetes and the metabolic syndrome (7,8). One prospective cohort study in the U.S. showed that heme iron intake from red meat sources was positively associated with the risk of type 2 diabetes, whereas total iron intake and heme iron intake from non-red meat sources were not associated with the risk of type 2 diabetes (9). Anemia is a big health problem in many developing countries. The prevalence of anemia in China is high (15.2% on average) (10). Although there are different factors associated with low hemoglobin level, the most common cause of anemia in developing countries is iron deficiency (11). Interestingly, in a study from China, iron deficiency anemia was found to be independently associated with a reduced prevalence of gestational diabetes (12). One assumption was that this association could be an indicator of general nutritional deficiency.The Chinese food pattern is unique in that it is characterized by a high intake of cereals and vegetables and a low intake of animal foods. This would imply that the intake of heme iron is low and the bioavailability of dietary iron is low. We therefore set out to examine the association between hemoglobin, serum ferritin level, iron intake, and diabetes in a crosssectional study in the Jiangsu Province of China.RESEARCH DESIGN AND METHODS -I n 2 0 0 2 , C h i n a launched a national nutrition and hea...

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HBsAg Carrier Status and the Association Between Gestational Diabetes With Increased Serum Ferritin Concentration in Chinese Women

Cited by 72 publications

References 36 publications

Chronic hepatitis B viral infection independently predicts renal outcome in type 2 diabetic patients

Chronic hepatitis B viral infection independently predicts renal outcome in type 2 diabetic patients

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

Association Between Serum Ferritin, Hemoglobin, Iron Intake, and Diabetes in Adults in Jiangsu, China

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