Diabetes and prediabetes in patients with hepatitis B residing in North America

HBRN

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

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. (Hepatology 2015;62:1364-1374)

Original languageEnglish (US)
Pages (from-to)1364-1374
Number of pages11
JournalHepatology
Volume62
Issue number5
DOIs
StatePublished - Nov 1 2015

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Prediabetic State
North America
Hepatitis B
Odds Ratio
Fasting
Hepatitis B virus
Glucose
Alanine Transaminase
Hepatitis B Antigens
Chronic Hepatitis B
Obesity
Hypertension
Gastroenterology
Virus Diseases
Hyperlipidemias
Ethnic Groups
Canada
Antiviral Agents
Disease Progression
Liver Diseases

ASJC Scopus subject areas

  • Hepatology

Cite this

Diabetes and prediabetes in patients with hepatitis B residing in North America. / HBRN.

In: Hepatology, Vol. 62, No. 5, 01.11.2015, p. 1364-1374.

Research output: Contribution to journalArticle

@article{85a12f2cc7894980a4d888c76b3f7a5d,
title = "Diabetes and prediabetes in patients with hepatitis B residing in North America",
abstract = "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. (Hepatology 2015;62:1364-1374)",
author = "HBRN and Mandana Khalili and Manuel Lombardero and Chung, {Raymond T.} and Terrault, {Norah A.} and Ghany, {Marc G.} and Kim, {W. Ray} and Daryl Lau and Mauricio Lisker-Melman and Arun Sanyal and Lok, {Anna S.} and Roberts, {Lewis R.} and Smith, {Coleman I.} and {Di Bisceglie}, {Adrian M.} and Brunt, {Elizabeth M.} and Janssen, {Harry L A} and Wong, {David K.} and Joshua Juan and Jordan Feld and Colina Yim and Jenny Heathcote and Lee, {William M.} and Robert Perrillo and Son Do and Han, {Steven Huy B} and Tran, {Tram T.} and Cooper, {Stewart L.} and Fontana, {Robert J.} and Naoky Tsai and Fried, {Michael W.} and Keyur Patel and Donna Evon and Carithers, {Robert C.} and Margaret Shuhart and Kowdley, {Kris V.} and Wang, {Chia C.} and Sterling, {Richard K.} and {Jake Liang}, T. and Chang, {Kyong Mi} and Park, {Jang June} and Steven Belle and Abdus Wahed and Yona Cloonan and David Kleiner",
year = "2015",
month = "11",
day = "1",
doi = "10.1002/hep.28110",
language = "English (US)",
volume = "62",
pages = "1364--1374",
journal = "Hepatology",
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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

PY - 2015/11/1

Y1 - 2015/11/1

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. (Hepatology 2015;62:1364-1374)

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. (Hepatology 2015;62:1364-1374)

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