Chronic Hepatitis B More Prevalent in Those with Type 2 Diabetes

A staggering 29.1 million individuals are living with diabetes in the United States; which amounts to about one out of every 11 individuals living with diabetes. When it comes to diabetes, type 2 is the most prevalent form, but with the assistance of insulin, medication, healthy eating habits, and physical activity, it is manageable. However, a new study published in the Journal of Diabetes Investigation has shown that those with type 2 diabetes may have something else to worry about: hepatitis B (HBV).

Jun Lu, PhD, from the Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, and his colleagues from the university have found that those with type 2 diabetes have a higher prevalence of chronic hepatitis B virus infection (CHB) than those with adult onset-autoimmune diabetes and those who do not have diabetes at all.

According to the Hepatitis B Foundation, hepatitis B is a “global public health threat” that is 100 times more infectious than HIV; furthermore, it is the most common serious liver infection in the world. HBV, and HBV-related diseases, claim around 1 million individuals each year. About 5 to 10% of adults who are infected with the virus will go on to develop CHB. The good news is that 90% of them will recover if treated. The bad news is that diagnosis is sometimes delayed due to the fact that many of the individuals who have CHB do not present with telltale symptoms; this makes further understanding of CHB so important. With further understanding of where CHB tends to be prevalent, individuals can be diagnosed and started on treatment earlier, before severe damage is done.

Previous to this study, a link between CHB and a specific type of diabetes had not yet been established. In order to find answers, the research team set their sights on understanding if CHB prevalence varies by diabetes subtype.

To do this, the researchers conducted a cross-sectional study that included 381 participants with adult-onset autoimmune diabetes, 365 participants who had type 2 diabetes, and 1,365 participants who served as the “non-diabetic control” group. All of the participants came from the Chinese population and were recruited over the course of nine years: between June 2005 and February 2014. According to the study, anyone who tested positive for hepatitis C (HCV) antibodies, anyone with hepatic cirrhosis, or “malignant neoplasm and severe renal dysfunction (serum creatinine > 450 umol/L)” were excluded from the study. Furthermore, the “patients were grouped as HBV negative and CHB status.”

The researchers found that those with type 2 diabetes had higher CHB prevalence than the control group “(13.5% vs 10.0%, P=0.004)” and those with normal hepatic function “(13.3% vs. 8.8%, P=0.002). They found that when it comes to CHB prevalence between participants with adult-onset autoimmune diabetes and the control group, there was no difference. After the researchers adjusted for gender, age, and body index, “multiple logistic regression analysis indicated that the odds ratio of CHB increased ~ 1.5-fold in patients with type 2 diabetes than in the control group,” regardless of hepatic function.

Based on these findings, the authors concluded that “further research is required to ascertain whether CHB status increases the risk of developing type 2 diabetes, or whether type 2 diabetes, but not adult-onset autoimmune diabetes, increases the risk of CHB.” These findings are another important bit of understanding to add to our growing arsenal of knowledge regarding hepatitis B, allowing us to better fight it and potentially save a number of lives in the process.