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Published in: BMC Infectious Diseases 1/2019

Open Access 01-12-2019 | Hepatitis B | Research article

Maternal hepatitis B surface antigen carrier status increased the incidence of gestational diabetes mellitus

Authors: Songxu Peng, Zhihua Wan, Xiaofang Lin, Xiu Li, Yukai Du

Published in: BMC Infectious Diseases | Issue 1/2019

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Abstract

Background

The relationship between chronic hepatitis B virus (HBV) infection with gestational diabetes mellitus (GDM) remains unclear. This study aimed to identify the association between maternal HBsAg-positive status and GDM.

Methods

A retrospective cohort study was performed on the pregnant women who delivered from June 2012 to May 2016 at Wuhan Medical Care Center for Women and Children, Wuhan, China. We compared the incidence of GDM between HBsAg-positive pregnant women and HBsAg-negative controls. A multivariate regression model was used to measure the independent association between maternal HBsAg carrier and the risk of developing GDM.

Results

In total, 964 HBsAg-positive pregnant women and 964 HBsAg-negative women were included into the study. We observed maternal HBsAg carrier (OR 1.47, 95% CI 1.06–2.03), age (OR 1.05, 95% CI 1.00–1.10) and family history of diabetes (OR 3.97, 95% CI 2.05–7.67) had an independent risk for GDM in multivariable logistical regression model. However, no significant association was found between HBeAg carrier status, other HBV markers or viral load in pregnancy and the incidence of GDM.

Conclusions

Our results indicated that maternal HBsAg carriage is an independent risk factor for GDM, but viral activity indicated by HBeAg status and viral load is not the main reason for this phenomenon. Further studies are warranted to clarify the possible mechanisms behind such association of HBV infection and the additional risk of GDM.
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Literature
1.
go back to reference Schweitzer A, Horn J, Mikolajczyk RT, Krause G, Ott JJ. Estimations of worldwide prevalence of chronic hepatitis B virus infection: a systematic review of data published between 1965 and 2013. Lancet. 2015;386(10003):1546–55.CrossRef Schweitzer A, Horn J, Mikolajczyk RT, Krause G, Ott JJ. Estimations of worldwide prevalence of chronic hepatitis B virus infection: a systematic review of data published between 1965 and 2013. Lancet. 2015;386(10003):1546–55.CrossRef
2.
go back to reference Chen DS. Hepatitis B vaccination: the key towards elimination and eradication of hepatitis B. J Hepatol. 2009;50(4):805–16.CrossRef Chen DS. Hepatitis B vaccination: the key towards elimination and eradication of hepatitis B. J Hepatol. 2009;50(4):805–16.CrossRef
3.
go back to reference Sarri G, Westby M, Bermingham S, Hill-Cawthorne G, Thomas H, Guideline Development Group. Diagnosis and management of chronic hepatitis B in children, young people, and adults: summary of NICE guidance. BMJ. 2013;346:f3893.CrossRef Sarri G, Westby M, Bermingham S, Hill-Cawthorne G, Thomas H, Guideline Development Group. Diagnosis and management of chronic hepatitis B in children, young people, and adults: summary of NICE guidance. BMJ. 2013;346:f3893.CrossRef
4.
go back to reference Liu J, Zhang S, Wang Q, Shen H, Zhang M, Zhang Y, Yan D, Liu M. Seroepidemiology of hepatitis B virus infection in 2 million men aged 21–49 years in rural China: a population-based, cross-sectional study. Lancet Infect Dis. 2016;16(1):80–6.CrossRef Liu J, Zhang S, Wang Q, Shen H, Zhang M, Zhang Y, Yan D, Liu M. Seroepidemiology of hepatitis B virus infection in 2 million men aged 21–49 years in rural China: a population-based, cross-sectional study. Lancet Infect Dis. 2016;16(1):80–6.CrossRef
5.
go back to reference Te HS, Jensen DM. Epidemiology of hepatitis B and C viruses: a global overview. Clin Liver Dis. 2010;14(1):1–21.CrossRef Te HS, Jensen DM. Epidemiology of hepatitis B and C viruses: a global overview. Clin Liver Dis. 2010;14(1):1–21.CrossRef
6.
go back to reference Ott JJ, Stevens GA, Groeger J, Wiersma ST. Global epidemiology of hepatitis B virus infection: new estimates of age-specific HBsAg seroprevalence and endemicity. Vaccine. 2012;30(12):2212–9.CrossRef Ott JJ, Stevens GA, Groeger J, Wiersma ST. Global epidemiology of hepatitis B virus infection: new estimates of age-specific HBsAg seroprevalence and endemicity. Vaccine. 2012;30(12):2212–9.CrossRef
7.
go back to reference Shen L, Wang F, Wang F, Cui F, Zhang S, Zheng H, Zhang Y, Liang X, Bi S. Efficacy of yeast-derived recombinant hepatitis B vaccine after being used for 12 years in highly endemic areas in China. Vaccine. 2012;30(47):6623–7.CrossRef Shen L, Wang F, Wang F, Cui F, Zhang S, Zheng H, Zhang Y, Liang X, Bi S. Efficacy of yeast-derived recombinant hepatitis B vaccine after being used for 12 years in highly endemic areas in China. Vaccine. 2012;30(47):6623–7.CrossRef
8.
go back to reference Deng L, Li X, Shi Z, Jiang P, Chen D, Ma L. Maternal and perinatal outcome in cases of fulminant viral hepatitis in late pregnancy. Int J Gynaecol Obstet. 2012;119(2):145–8.CrossRef Deng L, Li X, Shi Z, Jiang P, Chen D, Ma L. Maternal and perinatal outcome in cases of fulminant viral hepatitis in late pregnancy. Int J Gynaecol Obstet. 2012;119(2):145–8.CrossRef
9.
go back to reference Salemi JL, Whiteman VE, August EM, Chandler K, Mbah AK, Salihu HM. Maternal hepatitis B and hepatitis C infection and neonatal neurological outcomes. J Viral Hepat. 2014;21(11):e144–53.CrossRef Salemi JL, Whiteman VE, August EM, Chandler K, Mbah AK, Salihu HM. Maternal hepatitis B and hepatitis C infection and neonatal neurological outcomes. J Viral Hepat. 2014;21(11):e144–53.CrossRef
10.
go back to reference Connell LE, Salihu HM, Salemi JL, August EM, Weldeselasse H, Mbah AK. Maternal hepatitis B and hepatitis C carrier status and perinatal outcomes. Liver Int. 2011;31(8):1163–70.CrossRef Connell LE, Salihu HM, Salemi JL, August EM, Weldeselasse H, Mbah AK. Maternal hepatitis B and hepatitis C carrier status and perinatal outcomes. Liver Int. 2011;31(8):1163–70.CrossRef
11.
go back to reference Tse KY, Ho LF, Lao T. The impact of maternal HBsAg carrier status on pregnancy outcomes: a case-control study. J Hepatol. 2005;43(5):771–5.CrossRef Tse KY, Ho LF, Lao T. The impact of maternal HBsAg carrier status on pregnancy outcomes: a case-control study. J Hepatol. 2005;43(5):771–5.CrossRef
12.
go back to reference Reddick KL, Jhaveri R, Gandhi M, James AH, Swamy GK. Pregnancy outcomes associated with viral hepatitis. J Viral Hepat. 2011;18(7):e394–8.CrossRef Reddick KL, Jhaveri R, Gandhi M, James AH, Swamy GK. Pregnancy outcomes associated with viral hepatitis. J Viral Hepat. 2011;18(7):e394–8.CrossRef
13.
go back to reference Lao TT, Sahota DS, Suen SS, Law LW, Leung TY. Maternal HBsAg status and infant size--a Faustian bargain? J Viral Hepat. 2012;19(7):519–24.CrossRef Lao TT, Sahota DS, Suen SS, Law LW, Leung TY. Maternal HBsAg status and infant size--a Faustian bargain? J Viral Hepat. 2012;19(7):519–24.CrossRef
14.
go back to reference Lao TT, Sahota DS, Cheng YK, Law LW, Leung TY. Maternal hepatitis B surface antigen status and incidence of pre-eclampsia. J Viral Hepat. 2013;20(5):343–9.CrossRef Lao TT, Sahota DS, Cheng YK, Law LW, Leung TY. Maternal hepatitis B surface antigen status and incidence of pre-eclampsia. J Viral Hepat. 2013;20(5):343–9.CrossRef
15.
go back to reference Lao TT, Chan BC, Leung WC, Ho LF, Tse KY. Maternal hepatitis B infection and gestational diabetes mellitus. J Hepatol. 2007;47(1):46–50.CrossRef Lao TT, Chan BC, Leung WC, Ho LF, Tse KY. Maternal hepatitis B infection and gestational diabetes mellitus. J Hepatol. 2007;47(1):46–50.CrossRef
16.
go back to reference 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):3011–6.CrossRef 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):3011–6.CrossRef
17.
go back to reference Sirilert S, Traisrisilp K, Sirivatanapa P, Tongsong T. Pregnancy outcomes among chronic carriers of hepatitis B virus. Int J Gynaecol Obstet. 2014;126(2):106–10.CrossRef Sirilert S, Traisrisilp K, Sirivatanapa P, Tongsong T. Pregnancy outcomes among chronic carriers of hepatitis B virus. Int J Gynaecol Obstet. 2014;126(2):106–10.CrossRef
18.
go back to reference Lao TT, Chung MK, Cheung TK, Law LW. Antenatal hepatitis B and increased risk of gestational diabetes mellitus - implications for obstetric care. J Inf Secur. 2016;72(5):625–6. Lao TT, Chung MK, Cheung TK, Law LW. Antenatal hepatitis B and increased risk of gestational diabetes mellitus - implications for obstetric care. J Inf Secur. 2016;72(5):625–6.
19.
go back to reference Kong D, Liu H, Wei S, Wang Y, Hu A, Han W, Zhao N, Lu Y, Zheng Y. A meta-analysis of the association between gestational diabetes mellitus and chronic hepatitis B infection during pregnancy. BMC Res Notes. 2014;7:139.CrossRef Kong D, Liu H, Wei S, Wang Y, Hu A, Han W, Zhao N, Lu Y, Zheng Y. A meta-analysis of the association between gestational diabetes mellitus and chronic hepatitis B infection during pregnancy. BMC Res Notes. 2014;7:139.CrossRef
20.
go back to reference International Association of Diabetes and Pregnancy Study Groups Consensus Panel, Metzger BE, Gabbe SG, Persson B, Buchanan TA, Catalano PA, Damm P, Dyer AR, Leiva A, et al. International association of diabetes and pregnancy study groups recommendations on the diagnosis and classification of hyperglycemia in pregnancy. Diabetes Care. 2010;33(3):676–82.CrossRef International Association of Diabetes and Pregnancy Study Groups Consensus Panel, Metzger BE, Gabbe SG, Persson B, Buchanan TA, Catalano PA, Damm P, Dyer AR, Leiva A, et al. International association of diabetes and pregnancy study groups recommendations on the diagnosis and classification of hyperglycemia in pregnancy. Diabetes Care. 2010;33(3):676–82.CrossRef
21.
go back to reference Retnakaran R, Connelly PW, Sermer M, Zinman B, Hanley AJ. The impact of family history of diabetes on risk factors for gestational diabetes. Clin Endocrinol. 2007;67(5):754–60.CrossRef Retnakaran R, Connelly PW, Sermer M, Zinman B, Hanley AJ. The impact of family history of diabetes on risk factors for gestational diabetes. Clin Endocrinol. 2007;67(5):754–60.CrossRef
22.
go back to reference Cui AM, Cheng XY, Shao JG, Li HB, Wang XL, Shen Y, Mao LJ, Zhang S, Liu HY, Zhang L, et al. Maternal hepatitis B virus carrier status and pregnancy outcomes: a prospective cohort study. BMC Pregnancy Childbirth. 2016;16(1):87.CrossRef Cui AM, Cheng XY, Shao JG, Li HB, Wang XL, Shen Y, Mao LJ, Zhang S, Liu HY, Zhang L, et al. Maternal hepatitis B virus carrier status and pregnancy outcomes: a prospective cohort study. BMC Pregnancy Childbirth. 2016;16(1):87.CrossRef
23.
go back to reference Hedderson M, Ehrlich S, Sridhar S, Darbinian J, Moore S, Ferrara A. Racial/ethnic disparities in the prevalence of gestational diabetes mellitus by BMI. Diabetes Care. 2012;35(7):1492–8.CrossRef Hedderson M, Ehrlich S, Sridhar S, Darbinian J, Moore S, Ferrara A. Racial/ethnic disparities in the prevalence of gestational diabetes mellitus by BMI. Diabetes Care. 2012;35(7):1492–8.CrossRef
24.
go back to reference Strong C, Lee S, Tanaka M, Juon HS. Ethnic differences in prevalence and barriers of HBV screening and vaccination among Asian Americans. J Community Health. 2012;37(5):1071–80.CrossRef Strong C, Lee S, Tanaka M, Juon HS. Ethnic differences in prevalence and barriers of HBV screening and vaccination among Asian Americans. J Community Health. 2012;37(5):1071–80.CrossRef
25.
go back to reference Gomes CP, Torloni MR, Gueuvoghlanian-Silva BY, Alexandre SM, Mattar R, Daher S. Cytokine levels in gestational diabetes mellitus: a systematic review of the literature. Am J Reprod Immunol. 2013;69(6):545–57.PubMed Gomes CP, Torloni MR, Gueuvoghlanian-Silva BY, Alexandre SM, Mattar R, Daher S. Cytokine levels in gestational diabetes mellitus: a systematic review of the literature. Am J Reprod Immunol. 2013;69(6):545–57.PubMed
26.
go back to reference Bossick AS, Peters RM, Burmeister C, Kakumanu N, Shill JE, Cassidy-Bushrow AE. Antenatal inflammation and gestational diabetes mellitus risk among pregnant African-American women. J Reprod Immunol. 2016;115:1–5.CrossRef Bossick AS, Peters RM, Burmeister C, Kakumanu N, Shill JE, Cassidy-Bushrow AE. Antenatal inflammation and gestational diabetes mellitus risk among pregnant African-American women. J Reprod Immunol. 2016;115:1–5.CrossRef
27.
go back to reference He D, Li M, Guo S, Zhu P, Huang H, Yan G, Wu Q, Tao S, Tan Z, Wang Y. Expression pattern of serum cytokines in hepatitis B virus infected patients with persistently normal alanine aminotransferase levels. J Clin Immunol. 2013;33(7):1240–9.CrossRef He D, Li M, Guo S, Zhu P, Huang H, Yan G, Wu Q, Tao S, Tan Z, Wang Y. Expression pattern of serum cytokines in hepatitis B virus infected patients with persistently normal alanine aminotransferase levels. J Clin Immunol. 2013;33(7):1240–9.CrossRef
28.
go back to reference Elkrief L, Rautou PE, Sarin S, Valla D, Paradis V, Moreau R. Diabetes mellitus in patients with cirrhosis: clinical implications and management. Liver Int. 2016;36(7):936–48.CrossRef Elkrief L, Rautou PE, Sarin S, Valla D, Paradis V, Moreau R. Diabetes mellitus in patients with cirrhosis: clinical implications and management. Liver Int. 2016;36(7):936–48.CrossRef
29.
go back to reference Simcox JA, McClain DA. Iron and diabetes risk. Cell Metab. 2013;17(3):329–41.CrossRef Simcox JA, McClain DA. Iron and diabetes risk. Cell Metab. 2013;17(3):329–41.CrossRef
30.
go back to reference Kim CH, Kim HK, Bae SJ, Park JY, Lee KU. Association of elevated serum ferritin concentration with insulin resistance and impaired glucose metabolism in Korean men and women. Metabolism. 2011;60(3):414–20.CrossRef Kim CH, Kim HK, Bae SJ, Park JY, Lee KU. Association of elevated serum ferritin concentration with insulin resistance and impaired glucose metabolism in Korean men and women. Metabolism. 2011;60(3):414–20.CrossRef
Metadata
Title
Maternal hepatitis B surface antigen carrier status increased the incidence of gestational diabetes mellitus
Authors
Songxu Peng
Zhihua Wan
Xiaofang Lin
Xiu Li
Yukai Du
Publication date
01-12-2019
Publisher
BioMed Central
Published in
BMC Infectious Diseases / Issue 1/2019
Electronic ISSN: 1471-2334
DOI
https://doi.org/10.1186/s12879-019-3749-1

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