title: Comparison of type 2 diabetes mellitus incidence in different phases of hepatitis B virus infection: A meta-analysis.
abstract: Because whether hepatitis B virus infection increases the risk of type 2 diabetes mellitus has been a controversial topic, pair-wise and network meta-analyses of published literature were carried out to accurately evaluate the association between different phases of hepatitis B virus infection and the risk of type 2 diabetes mellitus.
  
  
  
  A comprehensive literature retrieval was conducted from the PubMed, Embase, Cochrane Library and Chinese Database to identify epidemiological studies on the association between hepatitis B virus infection and the risk of type 2 diabetes mellitus that were published from 1999 to 2015. A pair-wise meta-analysis of direct evidence was performed to estimate the pooled odds ratios and 95% confidence intervals. A network meta-analysis was conducted, including the construction of a network plot, inconsistency plot, predictive interval plot, comparison-adjusted funnel plot and rank diagram, to graphically link the direct and indirect comparisons between different hepatitis B virus infective phases.
  
  
  
  Eighteen publications (n=113 639) describing 32 studies were included in this meta-analysis. In the pair-wise meta-analysis, the pooled odds ratio for type 2 diabetes mellitus in chronic hepatitis B cirrhosis patients was 1.76 (95% confidence interval: 1.44-2.14) when compared with non-cirrhotic chronic hepatitis B patients. In the network meta-analysis, six comparisons of four hepatitis B virus infectious states indicated the following descending order for the risk of type 2 diabetes mellitus: hepatitis B cirrhosis patients, non-cirrhotic chronic hepatitis B patients, hepatitis B virus carriers and non-hepatitis B virus controls.
  
  
  
  This study suggests that hepatitis B virus infection is not an independent risk factor for type 2 diabetes mellitus, but the development of cirrhosis may increase the incidence of type 2 diabetes mellitus cirrhosis.
authors.affiliation: Department of Epidemiology and Medical Statistics, Nantong University, Nantong, China.
authors.forename: Yi
authors.initials: Y
authors.lastname: Shen
authors.affiliation: Department of Epidemiology and Medical Statistics, Nantong University, Nantong, China.
authors.forename: Sheng
authors.initials: S
authors.lastname: Zhang
authors.affiliation: Department of Epidemiology and Medical Statistics, Nantong University, Nantong, China.
authors.forename: Xulin
authors.initials: X
authors.lastname: Wang
authors.affiliation: Department of Epidemiology and Medical Statistics, Nantong University, Nantong, China.
authors.forename: Yuanyuan
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Analysis and testing center, Nantong University, Nantong, China.
authors.forename: Jian
authors.initials: J
authors.lastname: Zhang
authors.affiliation: Center for Liver Diseases, Nantong Third People's Hospital, Nantong University, Nantong, China.
authors.forename: Gang
authors.initials: G
authors.lastname: Qin
authors.affiliation: Department of Epidemiology and Medical Statistics, Nantong University, Nantong, China.
authors.forename: Wenchao
authors.initials: W
authors.lastname: Li
authors.affiliation: Department of Epidemiology and Medical Statistics, Nantong University, Nantong, China.
authors.forename: Kun
authors.initials: K
authors.lastname: Ding
authors.affiliation: Research Centre for Public Health, Tsinghua University, Beijing 100084, China.|Melbourne Sexual Health Centre, Alfred Health, Melbourne, Australia.|Central Clinical School, Faculty of Medicine, Monash University, Melbourne, Australia.|School of Public Health and Preventive Medicine, Faculty of Medicine, Monash University, Melbourne, Australia.
authors.forename: Lei
authors.initials: L
authors.lastname: Zhang
authors.affiliation: Department of Epidemiology and Medical Statistics, Nantong University, Nantong, China.|Qidong Third People's Hospital, Nantong, China.
authors.forename: Feng
authors.initials: F
authors.lastname: Liang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003924:Diabetes Mellitus, Type 2 / Q000175:diagnosis / Q000453:epidemiology*; D006515:Hepatitis B virus / Q000472:pathogenicity*; D019694:Hepatitis B, Chronic / Q000175:diagnosis / Q000453:epidemiology* / Q000821:virology; D006801:Humans; D015994:Incidence; D008103:Liver Cirrhosis / Q000453:epidemiology / Q000821:virology; D008875:Middle Aged; D016017:Odds Ratio; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D055815:Young Adult
keywords: hepatitis B virus; network meta-analysis; type 2 diabetes mellitus