Hepatitis A and B are Associated with an Increased Risk for Diabetes Mellitus

Program: Abstracts - Orals, Featured Poster Presentations, and Posters
Session: SUN 758-779-Cardiometabolic Risk & Vascular Biology
Clinical
Sunday, June 16, 2013: 1:45 PM-3:45 PM
Expo Halls ABC (Moscone Center)

Poster Board SUN-758
James Lin1, Rudruidee Karnchanasorn*2, Horng-Yih Ou3, Jean Huang4, Wei Feng1, Raynald Samoa1, Lee-Ming Chuang5 and Ken C Chiu1
1City of Hope National Medical Center, Duarte, CA, 2The University of Kansas Medical Center, Kansas City, KS, 3National Cheng-Kung University Medical College and Hospital, Tainan, Taiwan, 4Olive View-UCLA Medical Center, Sylmar, CA, 5National Taiwan Univesity Hospital, Taipei, Taiwan
Liver plays a major role in glucose and insulin metabolism. It is well established that hepatitis C infection is associated with an increased risk for diabetes mellitus (DM). However, there is no information about the relationship of DM with hepatitis A and B, which are more prevalent than hepatitis C. We examined the risk of DM based on the serological testing for hepatitis A and B. 

We used the sample set from the participants of the NHANES 2005-2010. The states of glucose tolerance were defined by the established ADA criteria based on HbA1c (A1c), fasting plasma glucose (FPG), and 2-hour plasma glucose (2hPG). Normal glucose tolerance (NGT) was defined by meeting all three criteria of A1c < 5.7%, FPG < 100 mg/dL, and 2hPG < 140 mg/dL. Abnormal glucose tolerance (AGT) was defined as neither NGT nor DM with either A1c 5.7-6.4%, FPG 100-125 mg/dL or 2hPG 140-199 mg/dL, and DM were defined by either A1c ≥ 6.5%, FPG ≥ 126 mg/dL, or 2hPG ≥ 200 mg/dL.  Categorical differences were examined by using Chi-square test. Logistic regression analysis was used to calculate the odds ratio (OR) with 95% confidence intervals (95%CI). We considered the following covariates: age, gender, BMI, race/ethnic group, current smoking and alcohol consumption, family history of diabetes, education, poverty index, and physical activity.

Among 5,545 subjects with hepatitis A antibody (HepA Ab) tested, the positive rate for HepA Ab was 42.52%. HepA Ab was positive in 37.77% of NGT, 47.19% of AGT, and 58.04% of DM subjects (P<0.000001). After adjustment for covariates, the seropositive HepA Ab subjects had an increased risk for AGT (OR: 1.27, 95%CI: 1.09-1.48) and also for DM (OR: 1.36, 95%CI: 1.08-1.72).

Among 16,763 subjects with hepatitis B surface antibody (HepBs Ab) tested, the positive rate for HepBs Ab was 22.56%. HepBs Ab was positive in 28.59% of NGT, 18.32% of AGT, and 11.20% of DM subjects (P<0.000001). After adjustment for covariates, the seropositive HepBs Ab is no longer protective for AGT (OR: 1.07, 95%CI: 0.97-1.17) and DM (OR: 0.92, 95%CI: 0.78-1.08).

Among 16,763 subjects with hepatitis B core antibody (HepBc Ab) tested, the positive rate for HepBc Ab was 6.04%. HepBc Ab was positive in 4.70% of NGT, 7.22% of AGT, and 8.11% of DM subjects (P<0.000001). After adjustment for covariates, the seropositive HepBc Ab subjects had an increased risk for DM (OR: 1.33, 95%CI: 1.07-1.65), but not for AGT (OR: 1.16, 95%CI: 0.99-1.36).

Among 16,763 subjects with hepatitis B surface antigen (HepBs Ag) tested, the positive rate for HepBsAg was 0.39%. HepBs Ag was positive in 0.35% of NGT, 0.42% of AGT, and 0.48% of DM subjects (P>0.05).

Our study provides the first report of the association of DM with hepatitis A and B (HepA Ab and HepBc Ab).  Due to a high prevalence of viral hepatitis, especially hepatitis A (up to 42.52% for HepA Ab), vaccination and the prevention of viral hepatitis may potentially decrease future risk of developing diabetes.

Disclosure: KCC: Speaker Bureau Member, Bristol-Myers Squibb, Speaker Bureau Member, Astra Zeneca. Nothing to Disclose: JL, RK, HYO, JH, WF, RS, LMC

*Please take note of The Endocrine Society's News Embargo Policy at http://www.endo-society.org/endo2013/media.cfm

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