Comparison of type 2 diabetes mellitus incidence in different phases of hepatitis B virus infection: A meta-analysis
Comparison of type 2 diabetes mellitus incidence in different phases of hepatitis B virus infection: A meta-analysis
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DOI：
10.1111/liv.13275
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发表时间：
2017-10-01
影响因子：
6.7
通讯作者：
Liang, Feng
中科院分区：
文献类型：
--
作者：
Shen, Yi;Zhang, Sheng;Liang, Feng
由于乙型肝炎病毒感染是否会增加2型糖尿病的风险一直是一个有争议的话题，我们对已发表的文献进行了配对和网络荟萃分析，以准确评估不同阶段乙型肝炎病毒感染与2型糖尿病风险之间的关系。方法综合检索PubMed、Embase、Cochrane图书馆和中文数据库1999 - 2015年发表的乙型肝炎病毒感染与2型糖尿病发病风险相关的流行病学研究。对直接证据进行两两荟萃分析，以估计合并优势比和95%置信区间。采用网络meta分析，构建网络图、不一致图、预测区间图、比较调整漏斗图和秩线图，将不同乙肝病毒感染期的直接和间接比较用图形化的方式联系起来。结果本meta分析纳入了18篇文献（n=113639），涉及32项研究。在双配对荟萃分析中，慢性乙型肝炎肝硬化患者与非肝硬化慢性乙型肝炎患者相比，2型糖尿病的合并优势比为1.76（95%可信区间：1.44-2.14）。在网络meta分析中，四种乙型肝炎病毒感染状态的六项比较显示，2型糖尿病风险的降序为：乙型肝炎肝硬化患者、非肝硬化慢性乙型肝炎患者、乙型肝炎病毒携带者和非乙型肝炎病毒对照组。结论乙型肝炎病毒感染不是2型糖尿病的独立危险因素，但肝硬化的发生可能增加2型糖尿病肝硬化的发生率。
BackgroundBecause 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.MethodsA 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.ResultsEighteen publications (n=113639) 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.ConclusionThis 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.