Chronic hepatitis B viral infection independently... : Diabetologia (original) (raw)

Chronic hepatitis B viral infection independently predicts renal outcome in type 2 diabetic patients

A. Y.S. Cheng
A. P.S. Kong
V. W.S. Wong
W. Y. So
H. L.Y. Chan
C. S. Ho
C. W.K. Lam
J. S. Tam
C. C. Chow
C. S. Cockram
J. C.N. Chan
P. C.Y. Tong

Diabetologia

(

)

1777

1784

August 2006

| DOI: 10.1007/s00125-006-0294-4

Abstract

Aims/hypothesis

We examined the association between chronic hepatitis B virus (HBV) infection and clinical outcomes in a consecutive cohort of Chinese patients with type 2 diabetes.

Subjects, materials and methods

Between 1995 and 1999, 2,838 type 2 diabetes patients underwent comprehensive assessments and blood screening for hepatitis B surface antigen (HBsAg). The risk of occurrence of cardiovascular events and end-stage renal disease (defined as need for dialysis, doubling of serum creatinine or serum creatinine ≥500 μmol/l) was compared between HBsAg-positive and HBsAg-negative groups.

Results

At baseline, HBV-infected patients (_n_=286, 10.1%) were younger (51.0±11.5 vs 53.7±12.7 years, _p_=0.004), had earlier onset of diabetes (51.0±11.5 vs 53.7±12.7 years, _p_=0.001) and a higher frequency of retinopathy (28 vs 22%, _p_=0.03) than non-HBV-infected patients. After a median follow-up of 3.5 years (interquartile range: 1.7-5.9 years) and adjustment of age, glycaemic control and other potential confounding factors, HBV-infected patients were more likely to develop end-stage renal disease than non-HBV infected patients (8.7 vs 6.4%) with a hazard ratio of 4.5 (95% CI 1.1-18.6). The difference in the frequency of cardiovascular endpoints was not statistically significant.

Conclusions

In Chinese type 2 diabetes patients, chronic HBV infection was associated with increased risk of end-stage renal disease, and this was independent of other potential confounding factors. Early identification of HBV status and close surveillance of renal function are important in patients with type 2 diabetes who are living in areas where HBV is endemic or who are at risk of chronic HBV infection.