title: Relationship between chronic hepatitis B and metabolic syndrome: A structural equation modeling approach.
abstract: OBJECTIVE
  Investigate the nature of the relationship between chronic hepatitis B virus (HBV) infection and metabolic syndrome among nondiabetic adults.
  
  
  METHODS
  This was a cross-sectional analysis of 17,030 nondiabetic adults (7437 males and 9593 females; mean age, 36.0 ± 3.9 years) in northern Taiwan from 2008 to 2009. The associations of hepatitis B surface antigen (HBsAg) seropositivity with metabolic syndrome and cardio-metabolic parameters were assessed. A structural equation model was constructed to elucidate the pathways between chronic HBV infection and individual cardiometabolic risk factors.
  
  
  RESULTS
  A total of 2982 (17.5%) participants were HBsAg-seropositive. Of the seropositive and seronegative subjects, 15.5 and 16.9% had metabolic syndrome, respectively. The HBsAg-seropositive subjects had a lower odds of having metabolic syndrome compared with the seronegative subjects irrespective of gender and age (OR: 0.76, 95% CI: 0.68-0.85). The inverse associations remained significant after adjusting for body mass index and serum alanine aminotransferase levels. HBsAg seropositivity was inversely associated with hypertriglyceridemia (OR: 0.59, 95% CI: 0.52-0.66), and low serum levels of high-density lipoprotein cholesterol (OR: 0.86, 95% CI: 0.79-0.93) after adjustments. The structural equation model revealed chronic HBV infection had a significant negative effect on dyslipidemia both in males (B = -0.054) and females (B = -0.064).
  
  
  CONCLUSIONS
  The inverse relationship between chronic HBV infection and metabolic syndrome may be attributable to the net beneficial effects on lipid profiles.
authors.affiliation: Department of Family Medicine, National Taiwan University Hospital, Taipei, Taiwan.
authors.forename: Chiao-Yu
authors.initials: CY
authors.lastname: Huang
authors.affiliation: Department of Family Medicine, National Taiwan University Hospital, Taipei, Taiwan.
authors.forename: Chia-Wen
authors.initials: CW
authors.lastname: Lu
authors.affiliation: Department of Family Medicine, National Taiwan University Hospital, Taipei, Taiwan.|Min-Sheng General Hospital, Taoyuan, Taiwan.
authors.forename: Yi-Lien
authors.initials: YL
authors.lastname: Liu
authors.affiliation: Department of Family Medicine, National Taiwan University Hospital, Taipei, Taiwan.|Department of Family Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan.|Department of Community and Family Medicine, National Taiwan University Hospital Yun-Lin Branch, Yunlin, Taiwan.
authors.forename: Chien-Hsieh
authors.initials: CH
authors.lastname: Chiang
authors.affiliation: Department of Family Medicine, National Taiwan University Hospital, Taipei, Taiwan.|Department of Family Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan.
authors.forename: Long-Teng
authors.initials: LT
authors.lastname: Lee
authors.affiliation: Department of Family Medicine, National Taiwan University Hospital, Taipei, Taiwan.|Department of Family Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan.|Office of Superintendent, National Taiwan University Hospital Bei-Hu Branch, Taipei, Taiwan.
authors.forename: Kuo-Chin
authors.initials: KC
authors.lastname: Huang
mesh_terms: D000328:Adult; D000410:Alanine Transaminase / Q000097:blood; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D050171:Dyslipidemias / Q000097:blood / Q000150:complications / Q000821:virology; D005260:Female; D006514:Hepatitis B Surface Antigens / Q000097:blood; D006515:Hepatitis B virus / Q000276:immunology; D019694:Hepatitis B, Chronic / Q000097:blood* / Q000150:complications / Q000821:virology; D006801:Humans; D015228:Hypertriglyceridemia / Q000097:blood / Q000150:complications / Q000821:virology; D008075:Lipoproteins, HDL / Q000097:blood; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood / Q000821:virology*; D015233:Models, Statistical; D012307:Risk Factors; D013624:Taiwan
chemical_list: D006514:Hepatitis B Surface Antigens; D008075:Lipoproteins, HDL; D000410:Alanine Transaminase