Abstract
Immunization is recommended for people with diabetes mellitus (DM), but little information is available on their seropositivity rates. To determine the impact of glucose tolerance state on seropositivity rate after hepatitis B vaccination, we included 7645 adult participants from the National Health and Nutrition Examination Survey 2005–2016 who reported three doses of hepatitis B vaccine and were seropositive for anti-hepatitis B surface antibody (≥ 12.0 mIU/mL), after exclusion of those positive for anti-hepatitis B core antibody and/or hepatitis B surface antigen. We classified the states of glucose tolerance as normal glucose tolerance (NGT, 61.68%), abnormal glucose tolerance (AGT, 26.02%), or DM (13.30%). We observed a stepwise decline in hepatitis B seropositivity rate from NGT (53.64%) to AGT (45.52%) to DM (28.84%) (P < 0.0001). We confirmed these results after standardization for age and BMI (P < 0.0001 for all subgroup analyses) and in subgroup analyses by gender and racial/ethnic group. Dysregulated glucose metabolism is associated with a decreased seropositivity rate after hepatitis B vaccination. Our observations suggest that regular follow-up screening for anti-hepatitis B surface antibody, with additional booster vaccination as necessary, is especially important in patients with DM. Whether a similar phenomenon exits for other vaccines, especially COVID-19, remains to be investigated.
Highlights
Immunization is recommended for people with diabetes mellitus (DM), but little information is available on their seropositivity rates
We observed that a progressive decrease in seropositivity rate after hepatitis B vaccination was associated with deterioration of glucose tolerance
Age-standardized analyses confirmed a stepwise decline in seropositivity rate as glucose tolerance deteriorated in all groups except non-Hispanic Blacks, mainly with similar seropositivity rates between the Normal glucose tolerance (NGT) and Abnormal glucose tolerance (AGT) groups while a significant decrease in the DM group
Summary
Immunization is recommended for people with diabetes mellitus (DM), but little information is available on their seropositivity rates. The United States Centers for Disease Control and Prevention (CDC) recommends that adults with diabetes mellitus (DM) receive influenza, pneumococcal, Tdap (tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis), hepatitis B, and Zoster vaccines; this is endorsed by the American Diabetes Association (ADA) as a standard of medical care in d iabetes[1]. These recommendations were based on various observations. We used immunization history and the measurement of anti-hepatitis B surface antibody (anti-HBs), anti-hepatitis B core antibody (anti-HBc), and hepatitis B surface antigen (HBsAg) to determine the impact of glucose tolerance state on seropositivity rate of anti-hepatitis B surface antibody after hepatitis B vaccination in a representative adult population from the United States of America
Sign-in/Register to view highlights & summary 
Published Version (
Free)
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
