Division of Infectious Diseases, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea.
Department of Occupational and Environmental Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea.
J Viral Hepat. 2019 Jan;26(1):162-169. doi: 10.1111/jvh.13014. Epub 2018 Oct 29.
Hepatitis B virus (HBV) infection has been associated with a decreased prevalence of dyslipidaemia in cross-sectional studies, but cohort studies are limited. We investigated the longitudinal effects of chronic HBV infection on the development of dyslipidaemia. We performed a cohort study of 62 287 non-cirrhotic adult men and women free of dyslipidaemia who underwent serologic testing for hepatitis B surface antigen (HBsAg) and were followed annually or biennially for an average of 4.46 years. A parametric proportional hazard model was used to estimate the adjusted hazard ratio with 95% confidence interval (CI) for incident dyslipidaemia according to HBsAg seropositivity status. We identified 12 331 incident cases of hypercholesterolaemia during 278 004.4 person-years of follow-up (incident rate 44.4 per 1000 person-years). In models adjusted for age, sex, body mass index, year of screening exam, smoking status, alcohol intake, regular exercise and education level, the adjusted hazard ratios (95% CIs) for incident hypercholesterolaemia, high LDL cholesterolaemia; hypertriglyceridaemia, high non-HDL cholesterolaemia and low HDL cholesterolaemia comparing HBsAg-positive to HBsAg-negative participants was 0.71 (0.64-0.79), 0.83 (0.78-0.89), 0.61 (0.54-0.70), 0.69 (0.63-0.75) and 1.10 (0.98-1.24), respectively. An inverse association between HBsAg positivity and incident high apolipoprotein B were also identified, with a corresponding a hazard ratio of 0.63 (0.55-0.72). In a large cohort of apparently healthy Korean adults, HBsAg seropositivity was associated with lower risk of development of dyslipidaemia, suggesting a role of HBV infection in lipid metabolism.
乙型肝炎病毒（HBV）感染与横断面研究中血脂异常的患病率降低有关，但队列研究有限。我们研究了慢性 HBV 感染对血脂异常发展的纵向影响。我们对 62287 名无血脂异常的非肝硬化成年男女进行了队列研究，这些人接受了乙型肝炎表面抗原（HBsAg）的血清学检测，并平均随访了 4.46 年，每年或每两年随访一次。使用参数比例风险模型来估计根据 HBsAg 血清阳性状态发生血脂异常的调整后危险比（95%置信区间）。我们在 278004.4 人年的随访期间发现了 12331 例高胆固醇血症的新发病例（发病率为 44.4/1000 人年）。在调整年龄、性别、体重指数、筛查检查年份、吸烟状况、饮酒量、定期运动和教育水平后，与 HBsAg 阴性相比，HBsAg 阳性发生高胆固醇血症、高 LDL 胆固醇血症、高甘油三酯血症、高非 HDL 胆固醇血症和低 HDL 胆固醇血症的调整后危险比（95%CI）分别为 0.71（0.64-0.79）、0.83（0.78-0.89）、0.61（0.54-0.70）、0.69（0.63-0.75）和 1.10（0.98-1.24）。还发现 HBsAg 阳性与新发生高载脂蛋白 B 之间存在负相关，相应的危险比为 0.63（0.55-0.72）。在一项针对韩国成年人的大型队列研究中，HBsAg 血清阳性与血脂异常的发生风险降低相关，表明 HBV 感染在脂质代谢中发挥作用。
