Incidence of Diabetes in Persons With Chronic Hepatitis B
Incidence of Diabetes in Persons With Chronic Hepatitis B
To investigate the effect of hepatitis B virus (HBV) infection on the development of diabetes mellitus (DM), we compared DM incidence and characteristics of Alaska Native persons with and without HBV infection. From 1990 to 2010, there were 52 incident DM cases among 1309 persons with infection vs 4557 DM cases among 85 698 persons without infection (log-rank test, P = 0.20). Compared to infected persons without DM, those with DM were significantly older (57.0 vs 47.4 years, P < 0.001) and had higher body mass index (34.5 vs 28.4 kg/m, P < 0.001). Genotype, immune active disease and the presence of cirrhosis were not associated with DM. In this population-based cohort with over 20 years of follow-up, there was no effect of HBV infection on DM development.
While a relationship between chronic hepatitis C virus (HCV) infection and type 2 diabetes mellitus (DM) has been established, the effect of chronic hepatitis B virus (HBV) infection on the development of insulin resistance and DM is less clear. Chronic HBV infection has been a significant health disparity for Alaska Native persons, approximately 1600 (3%) of whom were found to be chronically infected when state-wide hepatitis B screening programmes were conducted in the 1980s. Although there is no systematic screening for elevated glucose levels among Alaska Native persons, an active diabetes registry has been operative in Alaska for more than 25 years, and persons who fit the American Diabetic Association criteria for DM have been entered into this registry and actively monitored. The coexistence of the DM and HBV registries for the Alaska Native population provides a unique opportunity to study the relationship between DM and chronic HBV infection in a population-based setting. To determine whether the presence of chronic HBV infection was associated with the subsequent development of DM, we compared the incidence of DM over a 20-year period among Alaska Native persons with chronic HBV infection with that of the overall Alaska Native population, as well as demographic, clinical and virologic characteristics of HBV-infected Alaska Native persons with and without DM.
Abstract and Introduction
Abstract
To investigate the effect of hepatitis B virus (HBV) infection on the development of diabetes mellitus (DM), we compared DM incidence and characteristics of Alaska Native persons with and without HBV infection. From 1990 to 2010, there were 52 incident DM cases among 1309 persons with infection vs 4557 DM cases among 85 698 persons without infection (log-rank test, P = 0.20). Compared to infected persons without DM, those with DM were significantly older (57.0 vs 47.4 years, P < 0.001) and had higher body mass index (34.5 vs 28.4 kg/m, P < 0.001). Genotype, immune active disease and the presence of cirrhosis were not associated with DM. In this population-based cohort with over 20 years of follow-up, there was no effect of HBV infection on DM development.
Introduction
While a relationship between chronic hepatitis C virus (HCV) infection and type 2 diabetes mellitus (DM) has been established, the effect of chronic hepatitis B virus (HBV) infection on the development of insulin resistance and DM is less clear. Chronic HBV infection has been a significant health disparity for Alaska Native persons, approximately 1600 (3%) of whom were found to be chronically infected when state-wide hepatitis B screening programmes were conducted in the 1980s. Although there is no systematic screening for elevated glucose levels among Alaska Native persons, an active diabetes registry has been operative in Alaska for more than 25 years, and persons who fit the American Diabetic Association criteria for DM have been entered into this registry and actively monitored. The coexistence of the DM and HBV registries for the Alaska Native population provides a unique opportunity to study the relationship between DM and chronic HBV infection in a population-based setting. To determine whether the presence of chronic HBV infection was associated with the subsequent development of DM, we compared the incidence of DM over a 20-year period among Alaska Native persons with chronic HBV infection with that of the overall Alaska Native population, as well as demographic, clinical and virologic characteristics of HBV-infected Alaska Native persons with and without DM.
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