Mod Care J. In Press(In Press):e65664.
Published online 2017 July 24.
doi: 10.5812/modernc.65664.
Research Article
The Prevalence and Risk Factors of Type II Diabetes Mellitus Among
Patients with Hepatitis B Virus: A Descriptive Correlational Study
Azadeh Ebrahimzadeh,
1,*
Masood Ziaee,
1
Gholamreza Sharifzadeh,
1
Zohreh Azarkar,
1
Mohammad
Hasan Namaei,
1
Mahmood Zardast,
1
Mahboubeh Saljoughi,
2
and Samira Elhamirad
3
1
Infectious Diseases Research Center, Birjand University of Medical Sciences, Birjand, Iran
2
MSc Clinical Psychology, Sabzevar University of Medical Sciences, Sabzevar, Iran
3
Department of Health Services Management, Faculty of Health, Zabol University of Medical Sciences, Zabol, Iran
*
Corresponding author: Azadeh Ebrahimzadeh, Infectious Diseases Research Center, Birjand University of Medical Sciences, Birjand, Iran. Tel: +98-9153613525, E-mail:
mr14436@yahoo.com
Received 2017 May 02; Accepted 2017 June 04.
Abstract
Background: There are 350 million carriers of hepatitis B virus (HBV) around the world. HBV can be associated with type II diabetes
mellitus. The aim of this study was to evaluate the prevalence and risk factors for type II diabetes mellitus among patients with HBV.
Methods: This community-based, cross sectional, descriptive, correlational study recruited participants above 13 years, who resided
in Esfandiar rural area, Tabas, Iran. A blood sample was collected from each participant for serological and biochemical tests. A
researcher-made questionnaire was used to collect data on the participants’ demographic characteristics, HBV risk factors, and
diabetes mellitus risk factors. Independent sample t test, Chi square test, and Fisher’s exact test were applied in SPSS v. 22.0 at a
significance level of < 0.05.
Results: This study was conducted on 1245 rural dwellers, with the mean age of 36.5 ± 18.5 years (range, 13 - 96 years). The study
population consisted of 676 (54.3%) males and 569 (45.7%) females. The prevalence of type II diabetes mellitus and hepatitis B sur-
face antigen (HBsAg) seropositivity was 7.6% (n, 95) and 12.5% (n, 156) among the participants, respectively. Moreover, the prevalence
of HBsAg seropositivity among diabetic patients was insignificantly higher than nondiabetic patients (15.8% vs. 12.3%; P = 0.32). The
prevalence of seropositivity among diabetic men was significantly higher than diabetic women (P = 0.02). The mean age, body
mass index, systolic and diastolic blood pressure, waist circumference, and hemoglobin A1c level were significantly higher among
diabetic, antigen-positive patients, compared to their nondiabetic counterparts (P < 0.05). However, these groups were not signifi-
cantly different with respect to alanine aminotransferase and aspartate aminotransferase levels (P > 0.05).
Conclusions: This study suggests that HBV can be a risk factor for type II diabetes mellitus. Therefore, continuous monitoring for
diabetes mellitus is essential for patients with HBV infection, particularly those above 50 years, those with a body mass index above
25 kg/m
2
, and those with a positive family history of type II diabetes mellitus.
Keywords: Type II Diabetes Mellitus, Hepatitis B, Prevalence, Risk Factor
1. Background
Diabetes mellitus (DM) is one of the most serious sys-
temic diseases around the world. The number of patients
with type II DM was 177 million in 2002, which is estimated
to reach 300 million by 2025 (1). The prevalence of type
II DM is expected to increase by 69% and 20% in develop-
ing and developed countries by 2030, respectively; also, the
number of diabetic patients will reach 24 million in Africa
(2).
On the other hand, hepatitis B virus (HBV) infection is
a serious and debilitating disease. Currently, there are 350
million carriers of HBV around the world (3). Each year, 877
000 people die due to the serious complications of HBV in-
fection, including cirrhosis and hepatocellular carcinoma
(4). The prevalence of HBV infection among Iranians be-
low 22 and 28 years is less than 0.5% and 1%, respectively.
Also, the prevalence of HBV infection is estimated at 1.6% in
Southern Khorasan province, Iran (5), while its prevalence
among adults ranges from 6.3% to 13.1% in this province (6).
Hepatitis and type II DM are interrelated in some ways.
According to previous research, 60% of patients with cir-
rhosis suffer from impaired glucose tolerance, while 20%
have type II DM. On the other hand, diabetic patients expe-
rience a wide range of liver problems from abnormal liver
function to hepatomegaly, hepatic steatosis, and steato-
hepatitis (7). Overall, liver plays a significant role in glucose
homeostasis. Therefore, liver inflammation and degenera-
tion during hepatitis alter glucose metabolism.
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