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A population-based study investigating the association between metabolic syndrome and Hepatitis B/C infection (Keelung Community-based Integrated Screening Study No. 10)

International Journal of Obesity volume 30, pages 794–799 (2006)Cite this article

Abstract

Objectives:

We aimed to assess the association between metabolic syndrome (MS) and hepatitis B/C virus infection using a large population-based study.

Design and methods:

A population-based cross-sectional study design was adopted with a total of 53 528 subjects being enrolled from the integrated multiple diseases screening program in Keelung, Taiwan. Evidence of past hepatitis B/C infection, acquired during childhood or as a young adult, was identified during the two-stage liver cancer screening part of the process. Information on biochemical markers and anthropometric measures related to MS, such as fasting blood sugar, triglyceride and high-density lipoprotein (HDL), abdominal circumference and blood pressure (BP), were collected routinely while screening for hypertension, type 2 diabetes, and hyperlipidemia. Logistic regression was used to estimate odds ratios and related 95% confidence intervals for the associations between MS and hepatitis B/C infection.

Results:

High blood pressure (SBP⩾135 mmHg or DBP⩾85 mmHg) (adjusted odd ratio: 0.89 (0.83–0.94)) and high triglyceride (⩾150 mg/dl) (adjusted odds ratio: 0.65 (0.60–0.69)) were, after adjusting for gender and age, inversely associated with being HBsAg positive (P<0.05). The likelihood of developing MS was lower in the HBsAg positive than the HBsAg negative (adjusted odds ratio: 0.84 (0.76–0.93)). A positive association between being anti-HCV positive and having low serum HDL (male <40 mg/dl, female <50 mg/dl) was also noted (adjusted odds ratio: 1.61 (1.37–1.88) after controlling for gender and age). High triglyceride was inversely associated with being anti-HCV positive (adjusted odds ratio: 0.63 (0.55–0.71).

Conclusions:

There is an inverse association between MS and hepatitis B virus infection whereas the association was heterogeneous for HCV infection with a positive association with abnormal serum HDL but an inverse association with hypertriglyceridemia.

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References

  1. Eckel RH, Grundy SM, Zimmet PZ . The metabolic syndrome. Lancet 2005; 365: 1415–1428.

    Article  CAS  Google Scholar 

  2. Kanel GC, Radvan G, Peters RL . High-density lipoprotein cholesterol and liver disease. Hepatology 1983; 3: 343–348.

    Article  CAS  Google Scholar 

  3. Cicognani C, Malavolti M, Morselli-Labate AM et al. Serum lipid and lipoprotein patterns in patients with liver cirrhosis and chronic active hepatitis. Arch Intern Med 1997; 157: 792–796.

    Article  CAS  Google Scholar 

  4. Su TC, Lee YT, Cheng TJ, Chien HP, Wang JD . Chronic hepatitis B virus infection and dyslipidemia. J Formos Med Assoc 2004; 103: 286–291.

    PubMed  Google Scholar 

  5. Voisset C, Callens N, Blanchard E, Op De Beeck A, Dubuisson J, Vu-Dac N . High density lipoproteins facilitate hepatitis C virus entry through the Scavenger receptor class B type I. J Biol Chem 2005; 280: 7793–7799.

    Article  CAS  Google Scholar 

  6. Huo TI, Wu JC, Lee PC, Tsay SH, Chang FY, Lee SD . Diabetes mellitus as a risk factor of liver cirrhosis in patients with chronic hepatitis B virus infection. J Clin Gastroenterol 2000; 30: 250–254.

    Article  CAS  Google Scholar 

  7. Sangiorgio L, Attardo T, Gangemi R, Rubino C, Barone M, Lunetta M . Increased frequency of HCV and HBV infection in type 2 diabetic patients. Diabetes Res Clin Pract 2000; 48: 147–151.

    Article  CAS  Google Scholar 

  8. Lao TT, Tse KY, Chan LY, Tam KF, Ho LF . HBsAg carrier status and the association between gestational diabetes with increased serum ferritin concentration in Chinese women. Diabetes Care 2003; 26: 3011–3016.

    Article  Google Scholar 

  9. Fraser GM, Harman I, Meller N, Niv Y, Porath A . Diabetes mellitus is associated with chronic hepatitis C but not chronic hepatitis B infection. Isr J Med Sci 1996; 32: 526–530.

    CAS  PubMed  Google Scholar 

  10. Okan V, Araz M, Aktaran S, Karsligil T, Meram I, Bayraktaroglu Z et al. Increased frequency of HCV but not HBV infection in type 2 diabetic patients in Turkey. Int J Clin Pract 2002; 56: 175–177.

    CAS  PubMed  Google Scholar 

  11. Bedarida G, D'Agostino F, Bianchi M, Susani G, Sangalli F, Fattorini A et al. Unexpected lower prevalence of HBsAg in diabetics than in controls (A study on 2465 patients). Ric Clin Lab 1982; 12: 409–415.

    CAS  PubMed  Google Scholar 

  12. Ozyilkan E, Ozyilkan O, Firat D, Telatar H . Hepatitis C virus antibody in patients with primary liver cancer (hepatocellular carcinoma, cholangiocarcinoma, and combined hepatocellular-cholangiocarcinoma) in Japan. Cancer 1994; 73: 2002–2003.

    Article  CAS  Google Scholar 

  13. Grimbert S, Valensi P, Levy-Marchal C, Perret G, Richardet JP, Raffoux C et al. High prevalence of diabetes mellitus in patients with chronic hepatitis C. A case–control study. Gastroenterol Clin Biol 1996; 20: 544–548.

    CAS  PubMed  Google Scholar 

  14. Knobler H, Schihmanter R, Zifroni A, Fenakel G, Schattner A . Increased risk of type 2 diabetes in noncirrhotic patients with chronic hepatitis C virus infection. Mayo Clinic Proc 2000; 75: 355–359.

    Article  CAS  Google Scholar 

  15. Wang CS, Wang ST, Yao WJ, Chang TT, Chou P . Community-based study of hepatitis C virus infection and type 2 diabetes: an association affected by age and hepatitis severity status. Am J Epidemiol 2003; 158: 1154–1160.

    Article  Google Scholar 

  16. Arao M, Murase K, Kusakabe A, Yoshioka K, Fukuzawa Y, Ishikawa T et al. Prevalence of diabetes mellitus in Japanese patients infected chronically with hepatitis C virus. J Gastroenterol 2003; 38: 355–360.

    Article  Google Scholar 

  17. Mehta SH, Brancati FL, Sulkowski MS, Strathdee SA, Szklo M, Thomas DL . Prevalence of type 2 diabetes mellitus among persons with hepatitis C virus infection in the United States. Ann Intern Med 2000; 133: 592–599.

    Article  CAS  Google Scholar 

  18. Lecube A, Hernandez C, Genesca J, Esteban JI, Jardi R, Simo R . High prevalence of glucose abnormalities in patients with hepatitis C virus infection: a multivariate analysis considering the liver injury. Diabetes Care 2004; 27: 1171–1175.

    Article  CAS  Google Scholar 

  19. Mangia A, Schiavone G, Lezzi G, Marmo R, Bruno F, Villani MR et al. HCV and diabetes mellitus: evidence for a negative association. Am J Gastroenterol 1998; 93: 2363–2367.

    Article  CAS  Google Scholar 

  20. Sung JL, Chen DS, Lai MY, Yu JY, Wang TH, Wang CY et al. Epidemiological study on hepatitis B virus infection in Taiwan. Chinese J Gastroenterol 1984; 1: 1–9.

    Google Scholar 

  21. Chang MH, Lee CY, Chen DS . Minimal role of hepatitis C virus infection in childhood liver diseases in an area hyperendemic for hepatitis B infection. J Med Virol 1993; 40: 322–325.

    Article  CAS  Google Scholar 

  22. Chen THH, Chiu YH, Luh DL, Yen MF, Wu HM, Chen LS et al. Taiwan Community-Based Integrated Screening Group Community-based multiple screening model: design, implementation, and analysis of 42,387 participants. Cancer 2004; 100: 1734–1743.

    Article  Google Scholar 

  23. Beisel WR . Metabolic response to infection. Annu Rev Med 1975; 26: 9–20.

    Article  CAS  Google Scholar 

  24. Grunfeld C, Feingold KR . Tumor necrosis factor, interleukin, and interferon induced changes in lipid, metabolism as part of host defense. Proc Soc Exp Biol Med 1992; 200: 224–227.

    Article  CAS  Google Scholar 

  25. Fabris C, Federico E, Soardo G, Falleti E, Pirisi M . Blood lipids of patients with chronic hepatitis: differences related to viral etiology. Clin Chim Acta 1997; 261: 159–165.

    Article  CAS  Google Scholar 

  26. Iannello S, Cavaleri A, Milazzo P, Cantarella S, Belfiore F . Low fasting serum triglyceride level as a precocious marker of autoimmune disorders. Med Gen Med 2003; 5: 20.

    Google Scholar 

  27. Takemura Y, Kobayashi H, Kamachi M, Sekiguchi S, Shioikari M, Tamura M . Pathogenesis-screening tests for liver dysfunction in the asymptomatic patients with elevated ALT values and their diagnostic efficacies in primary care medcine. Rinsho Byori 1996; 44: 261–266.

    CAS  PubMed  Google Scholar 

  28. Wang CS, Chang TT, Chou P . Differing characteristics of hepatitis B and C risk factors among elders in a rural area in Taiwan. J Gerontol A Biol Sci Med Sci 1998; 53: M107–M111.

    Article  CAS  Google Scholar 

  29. Angelico F, Del Ben M, Conti R, Francioso S, Feole K, Maccioni D et al. Non-alcoholic fatty liver syndrome: a hepatic consequence of common metabolic diseases. J Gastroenterol Hepatol 2003; 18: 588–594.

    Article  Google Scholar 

  30. Kang SK, Chung TW, Lee JY, Lee YC, Morton RE, Kim CH . The hepatitis B virus X protein inhibits secretion of apolipoprotein B by enhancing the expression of N-acetylglucosaminyltransferase III. J Biol Chem 2004; 279: 28106–28112.

    Article  CAS  Google Scholar 

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Authors and Affiliations

  1. Department of Family Medicine, National Taiwan University Hospital, College of Medicine, Taipei, Taiwan

    C-F Jan

  2. The Graduate Institute of Epidemiology, Taipei, Taiwan

    C-J Chen & H-M Wu

  3. The Institute of Health Informatics and Decision Making, National Yang-Ming University, Taipei, Taiwan

    C-C Huang, M-F Yen & T H-H Chen

  4. The Institute of Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan

    Y-H Chiu & L-S Chen

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  1. C-F Jan
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Correspondence to T H-H Chen.

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Jan, CF., Chen, CJ., Chiu, YH. et al. A population-based study investigating the association between metabolic syndrome and Hepatitis B/C infection (Keelung Community-based Integrated Screening Study No. 10). Int J Obes 30, 794–799 (2006). https://doi.org/10.1038/sj.ijo.0803204

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