The Impact of Hepatitis B Vaccination Status on the Risk of Diabetes, Implicating Diabetes Risk Reduction by Successful Vaccination.
BACKGROUND
The liver plays a key role in fuel metabolism. It is well established that liver disease is associated with an increased risk for diabetes mellitus. Hepatitis C virus infection has been known to increase the risk of diabetes. However, much less is known about the role of hepatitis B virus (HBV) infection in diabetes. We examined the association of diabetes based on the vaccination status for HBV.


METHODS
In this cross-sectional study, we included adult subjects (≥20 y/o) with HBV serology available from the National Health and Nutrition Examination Survey 2005-2010. Diabetes was defined as established diabetes or fasting plasma glucose concentration ≥7.0 mmol/L, 2-hour plasma glucose concentration ≥11.1 mmol/L, or HbA1c ≥ 47.5 mmol/mol (6.5%). Vaccination was based on the reported history and immunization was determined by HBV serology. The odds ratio (OR) with 95% confidence intervals (95% CI) were calculated with consideration of the following covariates: age, gender, BMI, ethnic/racial group, current smoker, current alcohol consumption, family history of diabetes, poverty index, and education.


RESULTS
This study included 15,316 subjects. Among them, 2,320 subjects was immunized based the HBV serology. Among 4,063 subjects who received HBV vaccination, successful vaccination was only noted in 39% of subjects. The HBV vaccination was not associated with diabetes (OR: 1.08, 95%CI: 0.96-1.23). Serology evidence of HBV immunization was associated with a reduced OR of diabetes (0.75, 95%CI: 0.62-0.90). Successful HBV vaccination was also associated with a reduced OR of diabetes (0.67, 95%CI: 0.52-0.84).


CONCLUSIONS
Although our study shows the association of HBV vaccination with the reduced odds of diabetes by 33%, a prospective study is warranted to confirm and examine the impact of HBV vaccination in prevention of diabetes.
Department of Clinical Diabetes, Endocrinology, and Metabolism, City of Hope National Medical Center, Duarte, California, United States of America; Division of Endocrinology, Metabolism and Nutrition, Department of Internal Medicine, Harbor-UCLA Medical Center, Torrance, California, United States of America.
Jean
J
Huang
Division of Endocrinology and Metabolism, Department of Internal Medicine, National Cheng-Kung University Medical College and Hospital, Tainan, Taiwan.
Horng-Yih
HY
Ou
Department of Gastroenterology, City of Hope National Medical Center, Duarte, California, United States of America.
James
J
Lin
Division of Endocrinology, Department of Medicine, University of Kansas Medical Center, Kansas City, Kansas, United States of America.
Rudruidee
R
Karnchanasorn
Department of Clinical Diabetes, Endocrinology, and Metabolism, City of Hope National Medical Center, Duarte, California, United States of America; Division of Endocrinology, Metabolism and Nutrition, Department of Internal Medicine, Harbor-UCLA Medical Center, Torrance, California, United States of America.
Wei
W
Feng
Department of Clinical Diabetes, Endocrinology, and Metabolism, City of Hope National Medical Center, Duarte, California, United States of America; Division of Endocrinology, Metabolism and Nutrition, Department of Internal Medicine, Harbor-UCLA Medical Center, Torrance, California, United States of America.
Raynald
R
Samoa
Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan; Graduate Institute of Preventive Medicine, School of Public Health, National Taiwan University, Taipei, Taiwan.
Lee-Ming
LM
Chuang
Department of Clinical Diabetes, Endocrinology, and Metabolism, City of Hope National Medical Center, Duarte, California, United States of America; Division of Endocrinology, Metabolism and Nutrition, Department of Internal Medicine, Harbor-UCLA Medical Center, Torrance, California, United States of America.
Ken C
KC
Chiu
D016001:Confidence Intervals; D003710:Demography; D003920:Diabetes Mellitus / Q000276:immunology*; D005260:Female; D006509:Hepatitis B / Q000097:blood / Q000276:immunology; D017325:Hepatitis B Vaccines / Q000276:immunology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D012307:Risk Factors; D040242:Risk Reduction Behavior; D014611:Vaccination
D017325:Hepatitis B Vaccines