title: General and Abdominal Adiposity and Risk of Death in HBV Versus Non-HBV Carriers: A 10-Year Population-based Cohort Study.
abstract: Both obesity and hepatitis B virus (HBV) infection increase the risk of death. We investigate the association between general and central obesity and all-cause mortality among adult Taiwanese HBV versus non-HBV carriers.A total of 19,850 HBV carriers and non-hepatitis C virus (HCV) carriers, aged 20 years and older at enrollment in 1998 to 1999 in Taiwan, were matched to 79,400 non-HBV and non-HCV carriers (1:4). Cox proportional-hazards models were used to estimate the relative risks for all-cause mortality during a maximum follow-up period of 10 years. Four obesity-related anthropometric indices-body mass index (BMI), waist circumference, waist-to-hip ratio, and waist-to-height ratio-were the main variables of interest.During the follow-up period, 628 and 2366 participants died among HBV and non-HBV carriers, respectively. Both underweight and general obesity were associated with an increased risk of death. The highest risk of all-cause death in relation to BMI was found in the HBV carriers with underweight (BMI <18.5 kg/m2) and non-HBV carriers with obesity (BMI ≥30 kg/m2). The lowest risks of all-cause death in relation to abdominal adiposity were found at the third quartiles of waist circumference, waist-to-hip ratio, and waist-to-height ratio among HBV carriers, but in the second quartiles among non-HBV carriers. For those with pre-existing liver disease among HBV carriers, patients with underweight have higher risk of death than those with obesity.Hepatitis B virus carriers with underweight have higher risk of death than non-HBV carriers. HBV carriers with mild abdominal obesity have the lowest risk of death, but not in the non-HBV carriers.
authors.affiliation: From the Department of Family Medicine (W-YL, C-CL); Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan (C-YP); School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan(W-YL, C-CL, C-YP); Department of Family Medicine, National Taiwan University Hospital, Taipei, Taiwan (W-YL, K-CH); Institute of Health Care Administration, College of Health Science, Asia University, Taichung, Taiwan (C-CL); MJ Health Screening Center, Taipei, Taiwan (P-KS); College of Life Sciences, Brigham Young University, Utah, USA (LED); and New York Presbyterian Hospital, Columbia University, New York, USA (FXP-S).
authors.forename: Wen-Yuan
authors.initials: WY
authors.lastname: Lin
authors.forename: Cheng-Yuan
authors.initials: CY
authors.lastname: Peng
authors.forename: Cheng-Chieh
authors.initials: CC
authors.lastname: Lin
authors.forename: Lance E
authors.initials: LE
authors.lastname: Davidson
authors.forename: F Xavier
authors.initials: FX
authors.lastname: Pi-Sunyer
authors.forename: Pei-Kun
authors.initials: PK
authors.lastname: Sung
authors.forename: Kuo-Chin
authors.initials: KC
authors.lastname: Huang
mesh_terms: D050153:Abdominal Fat; D050154:Adiposity; D000328:Adult; D015992:Body Mass Index; D016022:Case-Control Studies; D005260:Female; D019694:Hepatitis B, Chronic / Q000150:complications* / Q000401:mortality; D006801:Humans; D008297:Male; D009765:Obesity / Q000150:complications* / Q000401:mortality; D011446:Prospective Studies; D013624:Taiwan / Q000453:epidemiology; D055105:Waist Circumference; D065927:Waist-Height Ratio