title: Combined effects of hepatitis B virus infection and elevated alanine aminotransferase levels on dyslipidemia.
abstract: OBJECTIVE
  Although elevated alanine aminotransferase (ALT) levels are associated with lipid profiles, most studies do not consider the role of hepatitis B virus (HBV) infection. This study investigated the combined effects of HBV infection and elevated ALT levels on the lipid profiles of Taiwanese adults.
  
  
  METHODS
  A total of 7695 subjects were enrolled after an annual health examination. Dyslipidemia was defined as serum total cholesterol≥200 mg/dL, serum triglyceride≥150 mg/dL, high-density lipoprotein cholesterol<40 mg/dL in men or <50 mg/dL in women, or low-density lipoprotein cholesterol≥130 mg/dL. Multiple logistic regression analysis was performed to assess the associations between dyslipidemia, HBV infection, and elevated ALT levels.
  
  
  RESULTS
  Hepatitis B surface antigen positivity (HBV[+]) and elevated ALT levels (ALT[+], ≥50 U/L) were observed in 13.5% and 12.2% of the subjects, respectively. Multiple logistic analysis revealed that the HBV(+) group had a significantly lower odds ratios (ORs) for hypercholesterolemia (OR, 0.8), hypertriglyceridemia (OR, 0.7), and high low-density lipoprotein cholesterol levels (OR, 0.8); whereas, the subjects with elevated ALT levels had significantly higher ORs for all of the dyslipidemia criteria. The interaction between HBV(+) and ALT(+) had a significantly lower OR for hypertriglyceridemia (OR, 0.7). The subjects with HBV infections had a significantly lower OR for hypertriglyceridemia regardless of the ALT levels.
  
  
  CONCLUSIONS
  HBV infection and elevated ALT levels have opposite effects on dyslipidemia, whereas their combined effects result in a significantly lower OR for hypertriglyceridemia.
authors.affiliation: Department of Family Medicine, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan.
authors.forename: Peng-Tzu
authors.initials: PT
authors.lastname: Liu
authors.forename: An-Chun
authors.initials: AC
authors.lastname: Hwang
authors.forename: Jong-Dar
authors.initials: JD
authors.lastname: Chen
mesh_terms: D000410:Alanine Transaminase / Q000097:blood*; D001786:Blood Glucose / Q000378:metabolism; D002784:Cholesterol / Q000097:blood; D050171:Dyslipidemias / Q000201:enzymology* / Q000453:epidemiology / Q000821:virology*; D005260:Female; D006509:Hepatitis B / Q000201:enzymology* / Q000453:epidemiology / Q000821:virology; D006514:Hepatitis B Surface Antigens / Q000097:blood; D006515:Hepatitis B virus / Q000302:isolation & purification*; D006801:Humans; D008297:Male; D008875:Middle Aged; D018709:Statistics, Nonparametric; D013624:Taiwan / Q000453:epidemiology; D014280:Triglycerides / Q000097:blood
chemical_list: D001786:Blood Glucose; D006514:Hepatitis B Surface Antigens; D014280:Triglycerides; D002784:Cholesterol; D000410:Alanine Transaminase