Abstract
The role of hepatitis virus infection in glucose homeostasis is uncertain. We examined the associations between hepatitis B virus (HBV) or hepatitis C virus (HCV) infection and the development of diabetes in a cohort (N = 439,708) of asymptomatic participants in health screening examinations. In cross-sectional analyses, the multivariable-adjusted odds ratio for prevalent diabetes comparing hepatitis B surface antigen (HBsAg) (+) to HBsAg (−) participants was 1.17 (95% CI 1.06–1.31; P = 0.003). The corresponding odds ratio comparing hepatitis C antibodies (HCV Ab) (+) to HCV Ab (−) participants was 1.43 (95% CI 1.01–2.02, P = 0.043). In prospective analyses, the multivariable-adjusted hazard ratio for incident diabetes comparing HBsAg (+) to HbsAg (−) participants was 1.23 (95% CI 1.08–1.41; P = 0.007). The number of incident cases of diabetes among HCV Ab (+) participants (10 cases) was too small to reliably estimate the prospective association between HCV infection and diabetes. In this large population at low risk of diabetes, HBV and HCV infections were associated with diabetes prevalence and HBV infection with the risk of incident diabetes. Our studies add evidence suggesting that diabetes is an additional metabolic complication of HBV and HCV infection.
Highlights
Chronic viral hepatic infections are a major threat to public health worldwide
In addition to the prospective associations, we evaluated the cross-sectional associations of hepatitis virus infection and prevalent diabetes at baseline for comparability with previous studies
We examined the association between hepatitis B surface antigen (HBsAg) or hepatitis C virus (HCV) Ab status and incident diabetes
Summary
Chronic viral hepatic infections are a major threat to public health worldwide. Chronic hepatitis B virus (HBV) and hepatitis C virus (HCV) are the leading causes of cirrhosis and hepatocellular carcinoma, two conditions with increasing mortality and burden of disease especially in the developing countries[1, 2]. As the liver has a key role in glucose metabolism and adequate liver function is essential to maintain glucose homeostasis[3, 4], diabetes may be a complication of end-stage liver disease, especially in patients with chronic HCV infection[4,5,6,7]. Since diabetes is another major concern in public health, it is very important to establish if chronic viral hepatitis is associated with an increased risk of diabetes prior to the development of end-stage liver disease. In addition to the prospective associations, we evaluated the cross-sectional associations of hepatitis virus infection and prevalent diabetes at baseline for comparability with previous studies
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