title: Identifying patients with chronic hepatitis B at high risk of type 2 diabetes mellitus: a cross-sectional study with pair-matched controls.
abstract: BACKGROUND
  The presence of diabetes mellitus (DM) is associated with increased liver morbidity and mortality risk in patients with chronic hepatitis B (CHB). Aim of this study was to identify factors associated with type 2 diabetes mellitus (T2DM) in CHB patients.
  
  
  METHODS
  A cross-sectional study with pair-matched controls was conducted in Nantong Third People's Hospital, Nantong University, China. From January 2008 to December 2012, a total of 1783 CHB patients were screened for study subjects, among whom 207 patients with T2DM were enrolled as cases and 207 sex- and age-matched non-DM patients as controls. Demographic, anthropometric, lifestyle, clinical, and laboratory data were obtained from each subject.
  
  
  RESULTS
  In the univariate model, thirteen variables showed marked differences between the DM group and non-DM group. Patients with longer duration of CHB (≥15 years) and alcoholic steatosis showed the highest likelihood of T2DM (odds ratio = 5.39 and 4.95; 95% confidence intervals 2.76-10.53 and 1.65-14.91). In the multivariate adjusted analysis, three CHB-related factors, namely high viral load, long duration of illness, and presence of cirrhosis, contributed to substantially increase the likelihood of T2DM, in addition to the other five risk factors including family history of DM, low education level, elevated triglycerides (TG), gamma-glutamyl transferase (GGT) levels, and presence of alcoholic steatosis.
  
  
  CONCLUSIONS
  Our findings suggest that high viral load, long duration of CHB, presence of cirrhosis, alcoholic steatosis and several other factors may be potential risk factors for development of T2DM in CHB patients. It is of vital importance to monitor glucose in high-risk CHB patients and aggressively intervene on modifiable risk factors.
authors.affiliation: Department of Epidemiology and Medical Statistics, School of Public Health, Nantong University, Nantong, Jiangsu, 226019, China. sunny@ntu.edu.cn.|Center for Liver Diseases, Nantong Third People's Hospital, Nantong University, Nantong, Jiangsu, 226006, China. sunny@ntu.edu.cn.
authors.forename: Yi
authors.initials: Y
authors.lastname: Shen
authors.affiliation: Department of Epidemiology and Medical Statistics, School of Public Health, Nantong University, Nantong, Jiangsu, 226019, China. 269109654@qq.com.
authors.forename: Jian
authors.initials: J
authors.lastname: Zhang
authors.affiliation: Department of Epidemiology and Medical Statistics, School of Public Health, Nantong University, Nantong, Jiangsu, 226019, China. huicai2012@yahoo.com.
authors.forename: Hui
authors.initials: H
authors.lastname: Cai
authors.affiliation: Center for Liver Diseases, Nantong Third People's Hospital, Nantong University, Nantong, Jiangsu, 226006, China. shaojianguo4144@163.com.
authors.forename: Jian-Guo
authors.initials: JG
authors.lastname: Shao
authors.affiliation: Center for Liver Diseases, Nantong Third People's Hospital, Nantong University, Nantong, Jiangsu, 226006, China. youyizhang@ntu.edu.cn.
authors.forename: You-Yi
authors.initials: YY
authors.lastname: Zhang
authors.affiliation: Department of Epidemiology and Medical Statistics, School of Public Health, Nantong University, Nantong, Jiangsu, 226019, China. 13180014@yjs.ntu.edu.cn.
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, 226006, China. tonygqin@ntu.edu.cn.
authors.forename: Gang
authors.initials: G
authors.lastname: Qin
authors.affiliation: Department of Internal Medicine, Singapore General Hospital, Singapore, 169608, Singapore. qin.yan@sgh.com.sg.
authors.forename: Yan
authors.initials: Y
authors.lastname: Qin
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D002681:China / Q000453:epidemiology; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000453:epidemiology / Q000209:etiology* / Q000235:genetics; D004522:Educational Status; D005235:Fatty Liver, Alcoholic / Q000453:epidemiology; D005260:Female; D019694:Hepatitis B, Chronic / Q000097:blood / Q000150:complications* / Q000453:epidemiology; D006801:Humans; D015228:Hypertriglyceridemia / Q000453:epidemiology; D008103:Liver Cirrhosis / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D013997:Time Factors; D019562:Viral Load; D005723:gamma-Glutamyltransferase / Q000097:blood
chemical_list: D005723:gamma-Glutamyltransferase