Zhang Jian, Shen Yi, Cai Hui, Liu Yan-Mei, Qin Gang
Department of Epidemiology and Medical Statistics.
Department of Medicine, Vanderbilt Epidemiology Center and Vanderbilt-Ingram Cancer Center, Vanderbilt University, Nashville, USA.
Hepatol Res. 2015 Nov;45(11):1100-9. doi: 10.1111/hepr.12481. Epub 2015 Feb 15.
Whether hepatitis B virus (HBV) infection increases the risk of type 2 diabetes mellitus (T2DM) is controversial. We carried out a meta-analysis to evaluate the association between HBV infection status and the risk of T2DM.
The PubMed, Embase and Ovid databases were searched for relevant studies on an association between HBV infection and the risk of diabetes. Methodological quality was assessed using the adapted Newcastle-Ottawa Quality Assessment Scale. A fix- or random-effects model was used to summarize odd ratios (OR) and 95% confidence intervals (CI).
We included seven cohort studies, four case-control and four cross-sectional studies, involving 118 530 participants. The prevalence of T2DM differs by HBV infection status. Pooled estimators indicated a nearly twofold excess T2DM risk with hepatitis B cirrhosis (HBC) status. The summary OR of the risk of T2DM for HBC patients was 1.99 (95% CI, 1.08-3.65) when compared with the non-HBV individuals, and 1.74 (95% CI, 1.43-2.13) when compared with non-cirrhotic chronic hepatitis B (NC-CHB) patients. In contrast, no significant correlation was found between asymptomatic HBV carriers or NC-CHB patients and the incidence of diabetes, compared with non-HBV controls.
Our findings suggest that while HBV itself may not be pro-diabetic, the HBV-derived cirrhosis is an independent risk factor for T2DM.
乙型肝炎病毒（HBV）感染是否会增加2型糖尿病（T2DM）的风险存在争议。我们进行了一项荟萃分析，以评估HBV感染状态与T2DM风险之间的关联。
检索PubMed、Embase和Ovid数据库，查找有关HBV感染与糖尿病风险之间关联的相关研究。使用改编后的纽卡斯尔-渥太华质量评估量表评估方法学质量。采用固定效应或随机效应模型汇总比值比（OR）和95%置信区间（CI）。
我们纳入了7项队列研究、4项病例对照研究和4项横断面研究，涉及118530名参与者。T2DM的患病率因HBV感染状态而异。汇总估计表明，乙型肝炎肝硬化（HBC）状态下T2DM风险几乎高出两倍。与非HBV个体相比，HBC患者患T2DM风险的汇总OR为1.99（95%CI，1.08 - 3.65），与非肝硬化慢性乙型肝炎（NC-CHB）患者相比为1.74（95%CI，1.43 - 2.13）。相比之下，与非HBV对照相比，无症状HBV携带者或NC-CHB患者与糖尿病发病率之间未发现显著相关性。
我们的研究结果表明，虽然HBV本身可能不会导致糖尿病，但HBV引起的肝硬化是T2DM的一个独立危险因素。
