Serum HBV surface antigen positivity is associated with low prevalence of metabolic syndrome: A meta-analysis

Abstract

Background and aimAs there is conflicting evidence for the relationship between hepatitis B virus surface antigen (HBsAg) positivity and the prevalence of metabolic syndrome (MetS), we performed a meta-analysis to investigate whether HBsAg positivity affects the incidence of MetS.MethodsObservational studies on the relationship between HBsAg positivity and MetS were obtained from PubMed, Web of Science, and the Cochrane Library in April 2016. The pooled odds ratios (ORs) of MetS and its components (central obesity, increased fasting glucose, increased blood pressure, dyslipidemia) for subjects with or without HBsAg positivity were synthesized. The standardized mean difference of MetS components between HBsAg-positive participants and healthy controls was calculated. Heterogeneity was explored with subgroup analysis and sensitivity analysis. Publication bias was detected using Egger’s test and Begg’s test.ResultsThirty studies were eligible for meta-analysis. The MetS OR for HBsAg-positive participants was significantly decreased compared with the controls [OR = 0.80, 95% confidence interval (CI), 0.70–0.90]. The negative effect of HBsAg positivity on elevated triglycerides (OR = 0.62, 95% CI, 0.59–0.64) was strong, while that for increased fasting blood glucose was weak (OR = 0.94, 95% CI, 0.90–0.98). The pooled ORs of central obesity (OR = 0.97, 95% CI, 0.91–1.04), reduced high-density lipoprotein cholesterol (OR = 0.98, 95% CI, 0.83–1.14), and elevated blood pressure (OR = 1.00, 95% CI, 0.80–1.25) for HBsAg-positive participants were all not significantly different compared with the controls. No publication bias was detected.ConclusionsSerum HBsAg positivity is inversely associated with the prevalence of MetS. Among the five components of MetS, elevated triglycerides had the strongest inverse relationship with HBsAg positivity.

Chronic hepatitis B virus infection and risk of dyslipidaemia: A cohort study

“…A study using Korean National Health and Nutrition Examination Survey also showed an inverse association between HBsAg positivity and elevated triglycerides . A meta‐analysis of 14 cross‐sectional studies reported an inverse association between HBsAg positivity and elevated TGs with an odds ratio of 0.62 (95% CI, 0.59‐0.64), whereas HBsAg positivity was not associated with reduced HDL‐C in the same meta‐analysis of 13 studies . In the present large‐scale cohort study of apparently healthy individuals, we demonstrated a longitudinal association between HBsAg positivity and the development of dyslipidaemia over time.…”

“…Several clinical studies have evaluated whether chronic viral infection is associated with dyslipidaemia, and have demonstrated an inverse association between HBV infection and lipid profiles . Furthermore, a meta‐analysis of 14 cross‐sectional studies reported an inverse relationship between HBsAg positivity and hypertriglyceridaemia . However, the cross‐sectional design of these studies limited their ability to establish a temporal relationship between HBV infection and reduced levels of lipid profiles.…”

“…[5][6][7][8] Furthermore, a meta-analysis of 14 cross-sectional studies reported an inverse relationship between HBsAg positivity and hypertriglyceridaemia. 9 However, the cross-sectional design of these studies limited their ability to establish a temporal relationship between HBV infection and reduced levels of lipid profiles. To the best of our knowledge, no previous longitudinal studies have evaluated the association between HBV infection and the development of dyslipidaemia among subjects free of dyslipidaemia at baseline.…”

Systematic review: chronic viral hepatitis and metabolic derangement

“…45 The most recently published review including 12 articles and a forest plot revealed an odds ratio of 0.8 for MetS prevalence in hepatitis B surface antigen-positive subjects compared to healthy controls. 46 Taken together, these lines of evidence imply that the risk of MetS is not increased in HBV patients. On the contrary, HBV infection may have a protective effect against MetS.…”

“…A subgroup analysis suggested an inverse association in men and a sample population of under 45 years of age . The most recently published review including 12 articles and a forest plot revealed an odds ratio of 0.8 for MetS prevalence in hepatitis B surface antigen‐positive subjects compared to healthy controls …”