title: Hepatitis B virus infection status and risk of type 2 diabetes mellitus: A meta-analysis.
abstract: OBJECTIVE
  Whether hepatitis B virus (HBV) infection increases the risk of type 2 diabetes mellitus (T2DM) is controversial. We carried out a meta-analysis to evaluate the association between HBV infection status and the risk of T2DM.
  
  
  METHODS
  The PubMed, Embase and Ovid databases were searched for relevant studies on an association between HBV infection and the risk of diabetes. Methodological quality was assessed using the adapted Newcastle-Ottawa Quality Assessment Scale. A fix- or random-effects model was used to summarize odd ratios (OR) and 95% confidence intervals (CI).
  
  
  RESULTS
  We included seven cohort studies, four case-control and four cross-sectional studies, involving 118 530 participants. The prevalence of T2DM differs by HBV infection status. Pooled estimators indicated a nearly twofold excess T2DM risk with hepatitis B cirrhosis (HBC) status. The summary OR of the risk of T2DM for HBC patients was 1.99 (95% CI, 1.08-3.65) when compared with the non-HBV individuals, and 1.74 (95% CI, 1.43-2.13) when compared with non-cirrhotic chronic hepatitis B (NC-CHB) patients. In contrast, no significant correlation was found between asymptomatic HBV carriers or NC-CHB patients and the incidence of diabetes, compared with non-HBV controls.
  
  
  CONCLUSIONS
  Our findings suggest that while HBV itself may not be pro-diabetic, the HBV-derived cirrhosis is an independent risk factor for T2DM.
authors.affiliation: Department of Epidemiology and Medical Statistics.
authors.forename: Jian
authors.initials: J
authors.lastname: Zhang
authors.affiliation: Department of Epidemiology and Medical Statistics.
authors.forename: Yi
authors.initials: Y
authors.lastname: Shen
authors.affiliation: Department of Medicine, Vanderbilt Epidemiology Center and Vanderbilt-Ingram Cancer Center, Vanderbilt University, Nashville, USA.
authors.forename: Hui
authors.initials: H
authors.lastname: Cai
authors.affiliation: Department of Epidemiology and Medical Statistics.
authors.forename: Yan-Mei
authors.initials: YM
authors.lastname: Liu
authors.affiliation: Center for Liver Diseases, Nantong Third People's Hospital, Nantong University, Nantong, Jiangsu, China.
authors.forename: Gang
authors.initials: G
authors.lastname: Qin
keywords: hepatitis B virus; meta-analysis; type 2 diabetes mellitus