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BMC Public Health
Published in: BMC Public Health 1/2014

Open Access 01-12-2014 | Research article

Association between hepatitis B virus infection and metabolic syndrome: a retrospective cohort study in Shanghai, China

Authors: Yanbing Zhou, Yan Cui, Haiju Deng, Jinming Yu

Published in: BMC Public Health | Issue 1/2014

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Abstract

Background

Metabolic syndrome (MS) and hepatitis B (HBV) infection are two major public health problems in China. There are few studies about their association, and the results of these studies are contradictory. We conducted a retrospective cohort study to assess the association between MS and HBV in a Shanghai community-based cohort.

Methods

Nine hundred seventy-six Shanghai residents were recruited from the Putuo community. 480 HBV infections were in exposed group and 496 non-infections in unexposed group. All metabolic-related parameters and hepatitis B serology were tested with routine biochemical or immunological methods. “Exposed” was defined by HBV infection represented by hepatitis B surface antigen (HBsAg) and without anti-virus treatment. “Unexposed” were subjects who didn’t infect with HBV (Represented by HBsAg) and no MS when they entered the cohort. MS was defined based on the updated National Cholesterol Education Program Adult Treatment Panel III criteria. The Cox proportional hazards model was used to estimate the hazard ratios (HR) and related 95% confidence intervals (95% CI) for the association between HBV infection and MS over a 20-year follow-up period.

Results

Of 976 subjects recruited, 480 had latent HBV infection (exposed subjects). After adjusting for age, the crude HR was 2.46 (95% CI: 1.77, 3.41). After adjusting for potential risk factors of MS (age, gender, smoking, passive smoking, alcohol consumption, physical activity, and diet), the HR was 2.27 (95% CI: 1.52, 3.38).

Conclusions

This 20-year follow-up retrospective cohort study in Shanghai showed a positive association between HBV infection and MS.
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Literature
1.
Lao XQ, Thomas GN, Jiang CQ, Zhang WS, Yin P, Adab P, Lam TH, Cheng KK: Association of the metabolic syndrome with vascular disease in an older Chinese population: Guangzhou Biobank Cohort Study. J Endocrinol Invest. 2006, 29 (11): 989-996. 10.1007/BF03349212.CrossRefPubMed
2.
Stern MP, Williams K, Gonzalez-Villalpando C, Hunt KJ, Haffner SM: Does the metabolic syndrome improve identification of individuals at risk of type 2 diabetes and/or cardiovascular disease?. Diabetes Care. 2004, 27 (11): 2676-2681. 10.2337/diacare.27.11.2676.CrossRefPubMed
3.
Cugati S, Wang JJ, Rochtchina E, Mitchell P: Ten-year incidence of diabetes in older Australians: the Blue Mountains Eye Study. Med J Aust. 2007, 186 (3): 131-135.PubMed
4.
Expert Panel on Detection E, Adults ToHBCi: Executive Summary of the Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). JAMA. 2001, 285 (19): 2486-2497. 10.1001/jama.285.19.2486.CrossRef
5.
Isomaa B, Almgren P, Tuomi T, Forsen B, Lahti K, Nissen M, Taskinen MR, Groop L: Cardiovascular morbidity and mortality associated with the metabolic syndrome. Diabetes Care. 2001, 24 (4): 683-689. 10.2337/diacare.24.4.683.CrossRefPubMed
6.
Trevisan M, Liu J, Bahsas FB, Menotti A: Syndrome X and mortality: a population-based study. Risk Factor and Life Expectancy Research Group. Am J Epidemiol. 1998, 148 (10): 958-966. 10.1093/oxfordjournals.aje.a009572.CrossRefPubMed
7.
Alberti KGMM, Zimmet P, Shaw J: The metabolic syndrome—a new worldwide definition. Lancet. 2005, 366 (9491): 1059-1062. 10.1016/S0140-6736(05)67402-8.CrossRefPubMed
8.
Weiss R, Dziura J, Burgert TS, Tamborlane WV, Taksali SE, Yeckel CW, Allen K, Lopes M, Savoye M, Morrison J, Sherwin RS, Caprio S: Obesity and the metabolic syndrome in children and adolescents. N Engl J Med. 2004, 350 (23): 2362-2374. 10.1056/NEJMoa031049.CrossRefPubMed
9.
Mo H: National epidemiological investigation report of hepatitis B virus serology. 2011, Beijing: People's Medical Publishing House
10.
Mason AL, Lau JY, Hoang N, Qian K, Alexander GJ, Xu L, Guo L, Jacob S, Regenstein FG, Zimmerman R, Everhart JE, Wasserfall C, Maclaren NK, Perrillo RP: Association of diabetes mellitus and chronic hepatitis C virus infection. Hepatology. 1999, 29 (2): 328-333. 10.1002/hep.510290235.CrossRefPubMed
11.
Hsu CS, Liu CJ, Liu CH, Chen CL, Lai MY, Chen PJ, Chen DS, Kao JH: Metabolic profiles in patients with chronic hepatitis C: a case–control study. Hepatol Int. 2008, 2 (2): 250-257. 10.1007/s12072-008-9064-3.CrossRefPubMedPubMedCentral
12.
Mehta SH, Brancati FL, Sulkowski MS, Strathdee SA, Szklo M, Thomas DL: Prevalence of type 2 diabetes mellitus among persons with hepatitis C virus infection in the United States. Ann Intern Med. 2000, 133 (8): 592-599. 10.7326/0003-4819-133-8-200010170-00009.CrossRefPubMed
13.
Adinolfi LE, Gambardella M, Andreana A, Tripodi MF, Utili R, Ruggiero G: Steatosis accelerates the progression of liver damage of chronic hepatitis C patients and correlates with specific HCV genotype and visceral obesity. Hepatology. 2001, 33 (6): 1358-1364. 10.1053/jhep.2001.24432.CrossRefPubMed
14.
Liu CJ, Jeng YM, Chen PJ, Lai MY, Yang HC, Huang WL, Kao JH, Chen DS: Influence of metabolic syndrome, viral genotype and antiviral therapy on superimposed fatty liver disease in chronic hepatitis C. Antivir Ther. 2005, 10 (3): 405-415.PubMed
15.
Huang JF, Chuang WL, Yu ML, Yu SH, Huang CF, Huang CI, Yeh ML, Hsieh MH, Yang JF, Lin ZY, Chen SC, Dai CY, Chang WY: Hepatitis C virus infection and metabolic syndrome–-a community-based study in an endemic area of Taiwan. Kaohsiung J Med Sci. 2009, 25 (6): 299-305. 10.1016/S1607-551X(09)70520-0.CrossRefPubMed
16.
Su TC, Lee YT, Cheng TJ, Chien HP, Wang JD: Chronic hepatitis B virus infection and dyslipidemia. J Formos Med Assoc. 2004, 103 (4): 286-291.PubMed
17.
Huo TI, Wu JC, Lee PC, Tsay SH, Chang FY, Lee SD: Diabetes mellitus as a risk factor of liver cirrhosis in patients with chronic hepatitis B virus infection. J Clin Gastroenterol. 2000, 30 (3): 250-254. 10.1097/00004836-200004000-00009.CrossRefPubMed
18.
Sangiorgio L, Attardo T, Gangemi R, Rubino C, Barone M, Lunetta M: Increased frequency of HCV and HBV infection in type 2 diabetic patients. Diabetes Res Clin Pract. 2000, 48 (2): 147-151. 10.1016/S0168-8227(99)00135-7.CrossRefPubMed
19.
Lao TT, Tse KY, Chan LY, Tam KF, Ho LF: HBsAg carrier status and the association between gestational diabetes with increased serum ferritin concentration in Chinese women. Diabetes Care. 2003, 26 (11): 3011-3016. 10.2337/diacare.26.11.3011.CrossRefPubMed
20.
Jan CF, Chen CJ, Chiu YH, Chen LS, Wu HM, Huang CC, Yen MF, Chen TH: A population-based study investigating the association between metabolic syndrome and hepatitis B/C infection (Keelung Community-based Integrated Screening study No. 10). Int J Obes (Lond). 2006, 30 (5): 794-799. 10.1038/sj.ijo.0803204.CrossRef
21.
Luo B, Wang Y, Wang K: Association of metabolic syndrome and hepatitis B infection in a Chinese population. Clin Chim Acta. 2007, 380 (1–2): 238-240.CrossRefPubMed
22.
Bedarida G, D'Agostino F, Bianchi M, Susani G, Sangalli F, Fattorini A, Sterza G: Unexpected lower prevalence of HBsAg in diabetics than in controls. (A study on 2,465 patients). Ric Clin Lab. 1982, 12 (2): 409-415.PubMed
23.
Lu JY, Su TC, Liu YH, Hsu HJ, Chen CL, Yang WS: Lower plasma adiponectin is correlated to higher alanine aminotransferase independent of metabolic factors and hepatitis B virus carrier status. Intern Med J. 2007, 37 (6): 365-371. 10.1111/j.1445-5994.2007.01364.x.CrossRefPubMed
24.
Lu JY, Chuang LM, Yang WS, Tai TY, Lai MY, Chen PJ, Kao JH, Lee CZ, Lee HS: Adiponectin levels among patients with chronic hepatitis B and C infections and in response to IFN-alpha therapy. Liver Int. 2005, 25 (4): 752-759. 10.1111/j.1478-3231.2005.1007.x.CrossRefPubMed
25.
Zhao J, Zhao Y, Wang H, Gu X, Ji J, Gao C: Association between metabolic abnormalities and HBV related hepatocelluar carcinoma in Chinese: a cross-sectional study. Nutr J. 2011, 10: 49-10.1186/1475-2891-10-49.CrossRefPubMedPubMedCentral
26.
Jinjuvadia R, Liangpunsakul S: Association between metabolic syndrome and its individual components with viral hepatitis B. Am J Med Sci. 2014, 347 (1): 23-27. 10.1097/MAJ.0b013e31828b25a5.CrossRefPubMed
27.
Li WC, Lee YY, Chen IC, Sun C, Chiu FH, Chuang CH: Association between the hepatitis B and C viruses and metabolic diseases in patients stratified by age. Liver Int. 2013, 33 (8): 1194-1202. 10.1111/liv.12224.CrossRefPubMed
28.
Jarcuska P, Janicko M, Kruzliak P, Novak M, Veseliny E, Fedacko J, Senajova G, Drazilova S, Madarasova-Geckova A, Marekova M, Pella D, Siegfried L, Kristián P, Kolesárová E, HepaMeta Study Group: Hepatitis B virus infection in patients with metabolic syndrome: A complicated relationship. Results of a population based study. Eur J Intern Med. 2014, 25 (3): 286-291. 10.1016/j.ejim.2014.01.006.CrossRefPubMed
29.
Hsu CS, Liu CH, Wang CC, Tseng TC, Liu CJ, Chen CL, Chen PJ, Chen DS, Kao JH: Impact of hepatitis B virus infection on metabolic profiles and modifying factors. J Viral Hepat. 2012, 19 (2): e48-e57. 10.1111/j.1365-2893.2011.01535.x.CrossRefPubMed
30.
Yen SL, Chiu TY, Lin YC, Lee YC, Lee LT, Huang KC: Obesity and hepatitis B infection are associated with increased risk of metabolic syndrome in university freshmen. Int J Obes (Lond). 2008, 32 (3): 474-480. 10.1038/sj.ijo.0803753.CrossRef
31.
Godsland IF, Stevenson JC: Insulin resistance: syndrome or tendency?. The Lancet. 1995, 346 (8967): 100-103. 10.1016/S0140-6736(95)92118-4.CrossRef
32.
Liu CJ, Chen PJ, Jeng YM, Huang WL, Yang WS, Lai MY, Kao JH, Chen DS: Serum adiponectin correlates with viral characteristics but not histologic features in patients with chronic hepatitis C. J Hepatol. 2005, 43 (2): 235-242. 10.1016/j.jhep.2005.02.044.CrossRefPubMed
33.
Hsu CS, Liu CJ, Liu CH, Wang CC, Chen CL, Lai MY, Chen PJ, Kao JH, Chen DS: High hepatitis C viral load is associated with insulin resistance in patients with chronic hepatitis C. Liver Int. 2008, 28 (2): 271-277.CrossRefPubMed
34.
Moucari R, Asselah T, Cazals-Hatem D, Voitot H, Boyer N, Ripault MP, Sobesky R, Martinot-Peignoux M, Maylin S, Nicolas-Chanoine MH, Paradis V, Vidaud M, Valla D, Bedossa P, Marcellin P: Insulin resistance in chronic hepatitis C: association with genotypes 1 and 4, serum HCV RNA level, and liver fibrosis. Gastroenterology. 2008, 134 (2): 416-423. 10.1053/j.gastro.2007.11.010.CrossRefPubMed
35.
Kao JH, Chen DS: Global control of hepatitis B virus infection. Lancet Infect Dis. 2002, 2 (7): 395-403. 10.1016/S1473-3099(02)00315-8.CrossRefPubMed
36.
Xu WH, Ruan XN, Fu XJ, Zhu QL, Zhang H, Bai Y, Wu HY, Zhou Y, Qiu H, Sun Q, Jiang QW, Yang LM, Gu JJ, Zhao GM: Prevalence of the metabolic syndrome in Pudong New Area of Shanghai using three proposed definitions among Chinese adults. BMC public health. 2010, 10: 246-10.1186/1471-2458-10-246.CrossRefPubMedPubMedCentral
37.
Ford ES, Giles WH, Dietz WH: Prevalence of the metabolic syndrome among US adults: findings from the third National Health and Nutrition Examination Survey. JAMA. 2002, 287 (3): 356-359. 10.1001/jama.287.3.356.CrossRefPubMed
38.
Park YW, Zhu S, Palaniappan L, Heshka S, Carnethon MR, Heymsfield SB: The metabolic syndrome: prevalence and associated risk factor findings in the US population from the Third National Health and Nutrition Examination Survey, 1988–1994. Arch Intern Med. 2003, 163 (4): 427-436. 10.1001/archinte.163.4.427.CrossRefPubMedPubMedCentral
39.
Lin WY, Yao CA, Wang HC, Huang KC: Impaired lung function is associated with obesity and metabolic syndrome in adults. Obesity (Silver Spring). 2006, 14 (9): 1654-1661. 10.1038/oby.2006.190.CrossRef
Metadata
Title
Association between hepatitis B virus infection and metabolic syndrome: a retrospective cohort study in Shanghai, China
Authors
Yanbing Zhou
Yan Cui
Haiju Deng
Jinming Yu
Publication date
01-12-2014
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2014
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/1471-2458-14-516

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