对HBV有免疫性可减少糖尿病风险

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肝脏在人体代谢中起着不可代替的作用。先前有研究表明，肝脏疾患会增加糖尿病风险。目前已知的HCV感染就显著增加糖尿病风险。不过HBV与糖尿病之间有没有类似关系仍不知道。

研究者进行了一项横断面研究，将糖尿病定义为：空腹血糖≥7.0 mmol/L，餐后2小时血糖 ≥11.1 mmol/L或HbA1c ≥ 47.5 mmol/mol (6.5%)。通过参与者自我报道和HBV相关血清学检查获取参与者免疫情况。

该研究共纳入了15,316名患者，基于血清学检查有 2,320名参与者对乙肝病毒有免疫性。 4,063名参与者接种了HBV疫苗，不过疫苗接种成功率只有39%。

研究数据显示HBV疫苗与糖尿病之间没有相关性(OR: 1.08, 95%CI: 0.96–1.23)。对HBV具有免疫性的血清学证据可以减少糖尿病风险(0.75, 95%CI: 0.62–0.90)。成功接种HBV疫苗也可以减少糖尿病风险(0.67, 95%CI: 0.52–0.84)。

研究结果表明，虽然成功接种HBV疫苗可以减少33%的糖尿病风险，不过对HBV疫苗和糖尿病的关系还需要更多的前瞻性研究。

来源：MedSci

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The Impact of Hepatitis B Vaccination Status on the Risk of Diabetes, Implicating Diabetes Risk Reduction by Successful Vaccination

Jean Huang , Horng-Yih Ou , James Lin , Rudruidee Karnchanasorn, Wei Feng, Raynald Samoa, Lee-Ming Chuang , Ken C. Chiu

Background
The liver plays a key role in fuel metabolism. It is well established that liver disease is associated with an increased risk for diabetes mellitus. Hepatitis C virus infection has been known to increase the risk of diabetes. However, much less is known about the role of hepatitis B virus (HBV) infection in diabetes. We examined the association of diabetes based on the vaccination status for HBV.

Methods
In this cross-sectional study, we included adult subjects (≥20 y/o) with HBV serology available from the National Health and Nutrition Examination Survey 2005–2010. Diabetes was defined as established diabetes or fasting plasma glucose concentration ≥7.0 mmol/L, 2-hour plasma glucose concentration ≥11.1 mmol/L, or HbA1c ≥ 47.5 mmol/mol (6.5%). Vaccination was based on the reported history and immunization was determined by HBV serology. The odds ratio (OR) with 95% confidence intervals (95% CI) were calculated with consideration of the following covariates: age, gender, BMI, ethnic/racial group, current smoker, current alcohol consumption, family history of diabetes, poverty index, and education.

Results
This study included 15,316 subjects. Among them, 2,320 subjects was immunized based the HBV serology. Among 4,063 subjects who received HBV vaccination, successful vaccination was only noted in 39% of subjects. The HBV vaccination was not associated with diabetes (OR: 1.08, 95%CI: 0.96–1.23). Serology evidence of HBV immunization was associated with a reduced OR of diabetes (0.75, 95%CI: 0.62–0.90). Successful HBV vaccination was also associated with a reduced OR of diabetes (0.67, 95%CI: 0.52–0.84).

Conclusions
Although our study shows the association of HBV vaccination with the reduced odds of diabetes by 33%, a prospective study is warranted to confirm and examine the impact of HBV vaccination in prevention of diabetes.

http://journals.plos.org/plosone ... ournal.pone.0139730