TY - JOUR
T1 - Diabetes and prediabetes in patients with hepatitis B residing in North America
AU - HBRN
AU - Khalili, Mandana
AU - Lombardero, Manuel
AU - Chung, Raymond T.
AU - Terrault, Norah A.
AU - Ghany, Marc G.
AU - Kim, W. Ray
AU - Lau, Daryl
AU - Lisker-Melman, Mauricio
AU - Sanyal, Arun
AU - Lok, Anna S.
AU - Roberts, Lewis R.
AU - Smith, Coleman I.
AU - Di Bisceglie, Adrian M.
AU - Brunt, Elizabeth M.
AU - Janssen, Harry L A
AU - Wong, David K.
AU - Juan, Joshua
AU - Feld, Jordan
AU - Yim, Colina
AU - Heathcote, Jenny
AU - Lee, William M.
AU - Perrillo, Robert
AU - Do, Son
AU - Han, Steven Huy B
AU - Tran, Tram T.
AU - Cooper, Stewart L.
AU - Fontana, Robert J.
AU - Tsai, Naoky
AU - Fried, Michael W.
AU - Patel, Keyur
AU - Evon, Donna
AU - Carithers, Robert C.
AU - Shuhart, Margaret
AU - Kowdley, Kris V.
AU - Wang, Chia C.
AU - Sterling, Richard K.
AU - Jake Liang, T.
AU - Chang, Kyong Mi
AU - Park, Jang June
AU - Belle, Steven
AU - Wahed, Abdus
AU - Cloonan, Yona
AU - Kleiner, David
N1 - Publisher Copyright:
© 2015 by the American Association for the Study of Liver Diseases.
PY - 2015/11
Y1 - 2015/11
N2 - Diabetes is associated with liver disease progression and increased hepatocellular carcinoma risk, but factors associated with diabetes in patients with chronic hepatitis B virus (HBV) infection in North America are unknown. We aimed to determine factors predictive of diabetes and impaired fasting glucose (IFG) in a large HBV-infected multiethnic cohort. Adults with chronic HBV not receiving antiviral therapy were enrolled from 21 centers in North America. Diabetes was defined by history/medication use or fasting glucose ≥126 mg/dL and IFG as fasting glucose 100-125 mg/dL. Of 882 patients included, 47.2% were female, 71.3% Asian, 83.7% foreign born, median age was 44 years, and median body mass index BMI 24.3 kg/m2. In this cohort, 26.0% were hepatitis B envelope antigen (HBeAg) positive, 43.9% had HBV DNA ≥20,000 IU/mL, and 26.7% alanine aminotransferase (ALT) ≥2× upper limit of normal (≥40 U/L women, ≥60 U/L men). Overall, 12.5% had diabetes and 7.8% IFG. The combined prevalence of diabetes or IFG was highest among blacks (36.7%) and those either born in the United States/Canada or foreign born with migration >20 years ago (25.5%). Obesity (odds ratio [OR]: 2.13), hyperlipidemia (OR, 4.13), hypertension (OR, 3.67), high ALT level (OR, 1.86), and family history of diabetes (OR, 3.43) were associated with diabetes. Factors associated with IFG were obesity (OR, 4.13) and hypertension (OR, 3.27), but also HBeAg positivity (OR, 0.39). Recent migration was negatively associated with diabetes among non-Asians (OR, 0.30). Conclusions: Diabetes is more prevalent in HBV-infected North American adults than the general population and is associated with known metabolic risk factors and liver damage, as determined by ALT levels. Among the foreign born, longer duration of North America residence predicted diabetes risk in non-Asians. These results highlight the opportunities for interventions to prevent diabetes especially among at-risk ethnic groups with HBV.
AB - Diabetes is associated with liver disease progression and increased hepatocellular carcinoma risk, but factors associated with diabetes in patients with chronic hepatitis B virus (HBV) infection in North America are unknown. We aimed to determine factors predictive of diabetes and impaired fasting glucose (IFG) in a large HBV-infected multiethnic cohort. Adults with chronic HBV not receiving antiviral therapy were enrolled from 21 centers in North America. Diabetes was defined by history/medication use or fasting glucose ≥126 mg/dL and IFG as fasting glucose 100-125 mg/dL. Of 882 patients included, 47.2% were female, 71.3% Asian, 83.7% foreign born, median age was 44 years, and median body mass index BMI 24.3 kg/m2. In this cohort, 26.0% were hepatitis B envelope antigen (HBeAg) positive, 43.9% had HBV DNA ≥20,000 IU/mL, and 26.7% alanine aminotransferase (ALT) ≥2× upper limit of normal (≥40 U/L women, ≥60 U/L men). Overall, 12.5% had diabetes and 7.8% IFG. The combined prevalence of diabetes or IFG was highest among blacks (36.7%) and those either born in the United States/Canada or foreign born with migration >20 years ago (25.5%). Obesity (odds ratio [OR]: 2.13), hyperlipidemia (OR, 4.13), hypertension (OR, 3.67), high ALT level (OR, 1.86), and family history of diabetes (OR, 3.43) were associated with diabetes. Factors associated with IFG were obesity (OR, 4.13) and hypertension (OR, 3.27), but also HBeAg positivity (OR, 0.39). Recent migration was negatively associated with diabetes among non-Asians (OR, 0.30). Conclusions: Diabetes is more prevalent in HBV-infected North American adults than the general population and is associated with known metabolic risk factors and liver damage, as determined by ALT levels. Among the foreign born, longer duration of North America residence predicted diabetes risk in non-Asians. These results highlight the opportunities for interventions to prevent diabetes especially among at-risk ethnic groups with HBV.
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U2 - 10.1002/hep.28110
DO - 10.1002/hep.28110
M3 - Article
C2 - 26390278
AN - SCOPUS:84945218153
SN - 0270-9139
VL - 62
SP - 1364
EP - 1374
JO - Hepatology
JF - Hepatology
IS - 5
ER -