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乙型肝炎病毒感染与糖尿病:中国开滦前瞻性队列研究

Hepatitis B virus infection and diabetes mellitus: the Kailuan prospective cohort study in China.

作者信息

Lei Shaoyuan, Chen Shuohua, Zhao Xinyu, Zhang Yanmin, Cheng Kailiang, Zhang Xiaohui, Wang Zhenyu, Sun Yuanyuan, Wu Shouling, Wang Li

机构信息

Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing, 100005, China.

Health Care Center, Kailuan Group, Tangshan, 063000, China.

出版信息

Hepatol Int. 2020 Sep;14(5):743-753. doi: 10.1007/s12072-020-10086-2. Epub 2020 Sep 3.

Abstract

BACKGROUND AND AIMS

The effect of hepatitis B virus (HBV) infection on diabetes has remained unclear. We thus conducted a prospective cohort study to investigate the association between different HBV infection status and new-onset diabetes in a Chinese population.

METHODS

We enrolled 55,520 participants with HBV serological markers and diabetes free in 2010 in Kailuan cohort. Cox regression models were used to analyze the relationship between different HBV infection status and incidence of diabetes after adjusting different confounders.

RESULTS

During an average follow-up of 5.6 years, we identified 6008 incident patients with diabetes. Compared to the participants with hepatitis B surface antigen (HBsAg) negative/hepatitis B surface antibody (anti-HBs) negative/hepatitis B core antibody (anti-HBc) negative, those with chronic HBV infection or with HBsAg negative/anti-HBc positive had a higher risk to occur diabetes. The hazard ratios were 1.18 (95% CI 0.99-1.40, p = 0.0588) and 1.22 (95% CI 1.08-1.36, p = 0.0009), respectively. The association between chronic HBV infection, anti-HBc positive and diabetes was different between those with different levels of high density lipoprotein cholesterol, blood pressure, body mass index, and age.

CONCLUSION

The individuals with chronic HBV infection or anti-HBc positive may have an increased risk of diabetes, and the association may be modified by the different status of metabolism related variables and age. Effective management of HBV infection may contribute to the reduction of the burden of both hepatitis B and diabetes.

摘要

背景与目的

乙型肝炎病毒(HBV)感染对糖尿病的影响尚不清楚。因此,我们进行了一项前瞻性队列研究,以调查中国人群中不同HBV感染状态与新发糖尿病之间的关联。

方法

我们纳入了2010年开滦队列中55520名有HBV血清学标志物且无糖尿病的参与者。采用Cox回归模型分析不同HBV感染状态与调整不同混杂因素后糖尿病发病率之间的关系。

结果

在平均5.6年的随访期间,我们确定了6008例糖尿病新发病例。与乙型肝炎表面抗原(HBsAg)阴性/乙型肝炎表面抗体(抗-HBs)阴性/乙型肝炎核心抗体(抗-HBc)阴性的参与者相比,慢性HBV感染或HBsAg阴性/抗-HBc阳性的参与者患糖尿病的风险更高。风险比分别为1.18(95%CI 0.99-1.40,p=0.0588)和1.22(95%CI 1.08-1.36,p=0.0009)。在不同水平的高密度脂蛋白胆固醇、血压、体重指数和年龄的参与者中,慢性HBV感染、抗-HBc阳性与糖尿病之间的关联有所不同。

结论

慢性HBV感染或抗-HBc阳性的个体患糖尿病的风险可能增加,且这种关联可能因代谢相关变量和年龄的不同状态而改变。有效管理HBV感染可能有助于减轻乙型肝炎和糖尿病的负担。

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