| Background and Objective:Hepatitis B is a transmitted disease caused by hepatitis B virus(HBV),which targets the liver and can cause damage to various organs.Nowdays,according to the data released in the 2015 China Hepatitis B Prevention and Control Guidelines,HBV infection is a public worldwide problem.There are about 93 million patients with chronic HBV infection in China,including 20 million chronic hepatitis B patients,which shows that the problem of HBV infection cannot be ignored.In addition to HBV infection,abnormal blood glucose is also a worldwide health problem.It is reported that about 9%of adults in the world have diabetes,which can further increase the risk of developing hepatocellular carcinoma(HCC)in patients with chronic viral hepatitis.A large amount of evidence indicates that hepatitis C virus infection has a higher correlation with the prevalence of diabetes,but the study of hepatitis B with diabetes is relatively scarce.With the improvement of the treatment rate of hepatitis B in China,more and more patients with chronic hepatitis B are getting viral suppression and complications such as diabetes,but the relationship between them is still controversial.The survey was conducted to explore and evaluate the prevalence and risk factors of diabetes and pre-diabetes in patients with chronic hepatitis B receiving antiviral therapies.Methods:This is a single-center,cross-sectional study.Based on inclusion and exclusion criteria,we selected 3,241 CHB patients who visited department of the infectious diseases of Nanfang Hospital from May 2014 to December 2017.With the assistance of trained staff,the sociodemographic status of the patient(eg age,gender),physical indicators(eg height,weight),personal health history(eg hypertension,diabetes,etc.),lifestyle(eg smoking,drinking),anti-HBV treatment history and other medical treatment history were evaluated,and blood for laboratory evaluation was collected by venipuncture at fasting state.In this study,Student’s t-test or non-parametric Mann-Whitney test was used to compare the mean±standard deviation of continuous variables.And we chose whether CHB patients had diabetes or pre-diabetes as the dependent variable,related influencing factors as independent variables to screen and analyze risk factors by logistic regression.ResultA total of 3,785 patients were enrolled in the cross-sectional study,excluding 73 patients without important data on blood glucose and 471 patients received interferon antiviral therapy.The final number of patients included in the study was 3241.The average age of the entire population was 40.05±9.96 years,and the patient population was mainly male(81.0%).Patients with HBV DNA undetectable(45.5%)and HBeAg negative(62.1%)were approximately half of the population.After stratified by host factors,the prevalence of pre-diabetes in patients 18-29,30-39,40-49,50-59,and 60-year-old was 0.80%(3/374),1.82%(24/1322),5.91%(58/982),11.00%(45/409),14.94%(23/154),and the prevalence of diabetes was 0%(0/374),1.51%(20/1322),4.38%(43/982),7.82%(32/409),9.09%(14/154),the prevalence of pre-diabetes and diabetes in patients with cirrhosis was significantly higher than Non-cirrhotic patients(7.99%vs 3.90%,P<0.001;6.30%vs 2.62%,P<0.001).Univariate logistic regression analysis and multivariate logistic regression analysis showed that age(per 10 years)(OR 1.838,P<0.001),male(OR 1.475,P=0.050),central obesity(OR 2.316,P<0.001)and hypertension(OR 1.743,P=0.007)were independent risk factors of pre-diabetes in CHB patients.What’s more,age(per 10 years)(OR 1.979,P<0.001),male(OR 10.877,P<0.001),smoking history(OR 1.722,P=0.010),central obesity(OR3.126,P<0.001)and cirrhosis(OR 2.218,P<0,001)were independent risk factors of diabetes in CHB.Conclusion:For CHB patients receiving antiviral therapies,we need to monitor the changes of their virological parameters as well as the blood glucose levels and pay close attention to diabetes and pre-diabetes for elder men,especially for those with hypertension and central obesity. |
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