Potential Protective Effect of Hepatitis B Immunity Against Diabetes Mellitus: A Retrospective Propensity-Matched Cohort Study

<b>Background</b>: Hepatitis B virus (HBV) infection affects glucose metabolism and increases diabetes risk; HBV vaccination may reduce this risk. The role of HBV immunity in diabetes prevention among individuals without HBV infection is underexplored. This study aims to evaluate whether...

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Main Authors: Nhu Quynh Phan, Shih-Jung Lin, Ngoc Hoang Le, Van Thuan Nguyen, Tan Ha Mai, Jin-Hua Chen, Min-Huei Hsu, Dinh Khanh Hoang, Phung Manh Thang, Ya-Li Huang, Chiehfeng Chen
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Language:English
Published: MDPI AG 2025-06-01
Series:Diagnostics
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Online Access:https://www.mdpi.com/2075-4418/15/13/1610
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author Nhu Quynh Phan
Shih-Jung Lin
Ngoc Hoang Le
Van Thuan Nguyen
Tan Ha Mai
Jin-Hua Chen
Min-Huei Hsu
Dinh Khanh Hoang
Phung Manh Thang
Ya-Li Huang
Chiehfeng Chen
author_facet Nhu Quynh Phan
Shih-Jung Lin
Ngoc Hoang Le
Van Thuan Nguyen
Tan Ha Mai
Jin-Hua Chen
Min-Huei Hsu
Dinh Khanh Hoang
Phung Manh Thang
Ya-Li Huang
Chiehfeng Chen
author_sort Nhu Quynh Phan
collection DOAJ
description <b>Background</b>: Hepatitis B virus (HBV) infection affects glucose metabolism and increases diabetes risk; HBV vaccination may reduce this risk. The role of HBV immunity in diabetes prevention among individuals without HBV infection is underexplored. This study aims to evaluate whether HBV immunity reduces diabetes risk in individuals without HBV infection. <b>Methods</b>: This retrospective cohort study used de-identified electronic medical records from TriNetX. Adults with hepatitis B surface antibody (HBsAb) results without a history of HBV infection or diabetes were identified. Diabetes was defined on the basis of a diabetes diagnosis, diabetes medication use, or glycated hemoglobin ≥ 6.5%. Propensity score matching was conducted to balance demographics and comorbidities between groups. <b>Results</b>: The HBV-immunized group had a 15% lower diabetes risk than the HBV-unimmunized group (HR: 0.85 [0.84–0.87]). A dose–response effect was observed, with higher HBsAb levels showing a greater reduction in the risk of diabetes. HBsAb levels of ≥100 and ≥1000 mIU/mL were associated with 19% (HR: 0.81 [0.80–0.83]) and 43% (HR: 0.57 [0.54–0.60]) reductions in diabetes risk, respectively, compared with HBsAb < 10 mIU/mL. The reduced risk of diabetes was associated with age. Immunized individuals aged 18 to 44 years, 45 to 64 years, and ≥65 years had 20% (HR: 0.80 [0.78–0.82]), 11% (HR: 0.89 [0.87–0.92]), and 12% (HR: 0.88 [0.84–0.91]) lower diabetes risks, respectively, compared with unimmunized individuals. <b>Conclusions:</b> HBV immunity may be associated with a reduced risk of diabetes, suggesting broader HBV vaccination as a dual-benefit strategy for the prevention of hepatitis B and diabetes, especially in regions with a high prevalence of both diseases.
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spelling doaj-art-aace97a893c74c72977e08c5c379fd002025-08-20T03:50:20ZengMDPI AGDiagnostics2075-44182025-06-011513161010.3390/diagnostics15131610Potential Protective Effect of Hepatitis B Immunity Against Diabetes Mellitus: A Retrospective Propensity-Matched Cohort StudyNhu Quynh Phan0Shih-Jung Lin1Ngoc Hoang Le2Van Thuan Nguyen3Tan Ha Mai4Jin-Hua Chen5Min-Huei Hsu6Dinh Khanh Hoang7Phung Manh Thang8Ya-Li Huang9Chiehfeng Chen10International Ph.D. Program in Medicine, College of Medicine, Taipei Medical University, Taipei 11031, TaiwanSchool of Medicine, College of Medicine, Taipei Medical University, Taipei 11031, TaiwanGraduate Institute of Biomedical Materials and Tissue Engineering, College of Biomedical Engineering, Taipei Medical University, Taipei 11031, TaiwanInternational Ph.D. Program in Medicine, College of Medicine, Taipei Medical University, Taipei 11031, TaiwanDepartment of Computer Science and Information Engineering, National Taiwan University, Taipei 10617, TaiwanGraduate Institute of Data Science, College of Management, Taipei Medical University, Taipei 11031, TaiwanGraduate Institute of Data Science, College of Management, Taipei Medical University, Taipei 11031, TaiwanInternational Ph.D. Program in Medicine, College of Medicine, Taipei Medical University, Taipei 11031, TaiwanDepartment of Infection Control, Cho Ray Hospital, Ho Chi Minh City 700000, VietnamDepartment of Public Health, School of Medicine, College of Medicine, Taipei Medical University, Taipei 11031, TaiwanDepartment of Public Health, School of Medicine, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan<b>Background</b>: Hepatitis B virus (HBV) infection affects glucose metabolism and increases diabetes risk; HBV vaccination may reduce this risk. The role of HBV immunity in diabetes prevention among individuals without HBV infection is underexplored. This study aims to evaluate whether HBV immunity reduces diabetes risk in individuals without HBV infection. <b>Methods</b>: This retrospective cohort study used de-identified electronic medical records from TriNetX. Adults with hepatitis B surface antibody (HBsAb) results without a history of HBV infection or diabetes were identified. Diabetes was defined on the basis of a diabetes diagnosis, diabetes medication use, or glycated hemoglobin ≥ 6.5%. Propensity score matching was conducted to balance demographics and comorbidities between groups. <b>Results</b>: The HBV-immunized group had a 15% lower diabetes risk than the HBV-unimmunized group (HR: 0.85 [0.84–0.87]). A dose–response effect was observed, with higher HBsAb levels showing a greater reduction in the risk of diabetes. HBsAb levels of ≥100 and ≥1000 mIU/mL were associated with 19% (HR: 0.81 [0.80–0.83]) and 43% (HR: 0.57 [0.54–0.60]) reductions in diabetes risk, respectively, compared with HBsAb < 10 mIU/mL. The reduced risk of diabetes was associated with age. Immunized individuals aged 18 to 44 years, 45 to 64 years, and ≥65 years had 20% (HR: 0.80 [0.78–0.82]), 11% (HR: 0.89 [0.87–0.92]), and 12% (HR: 0.88 [0.84–0.91]) lower diabetes risks, respectively, compared with unimmunized individuals. <b>Conclusions:</b> HBV immunity may be associated with a reduced risk of diabetes, suggesting broader HBV vaccination as a dual-benefit strategy for the prevention of hepatitis B and diabetes, especially in regions with a high prevalence of both diseases.https://www.mdpi.com/2075-4418/15/13/1610hepatitis Bvaccinationimmunitydiabetes mellitusprevention
spellingShingle Nhu Quynh Phan
Shih-Jung Lin
Ngoc Hoang Le
Van Thuan Nguyen
Tan Ha Mai
Jin-Hua Chen
Min-Huei Hsu
Dinh Khanh Hoang
Phung Manh Thang
Ya-Li Huang
Chiehfeng Chen
Potential Protective Effect of Hepatitis B Immunity Against Diabetes Mellitus: A Retrospective Propensity-Matched Cohort Study
Diagnostics
hepatitis B
vaccination
immunity
diabetes mellitus
prevention
title Potential Protective Effect of Hepatitis B Immunity Against Diabetes Mellitus: A Retrospective Propensity-Matched Cohort Study
title_full Potential Protective Effect of Hepatitis B Immunity Against Diabetes Mellitus: A Retrospective Propensity-Matched Cohort Study
title_fullStr Potential Protective Effect of Hepatitis B Immunity Against Diabetes Mellitus: A Retrospective Propensity-Matched Cohort Study
title_full_unstemmed Potential Protective Effect of Hepatitis B Immunity Against Diabetes Mellitus: A Retrospective Propensity-Matched Cohort Study
title_short Potential Protective Effect of Hepatitis B Immunity Against Diabetes Mellitus: A Retrospective Propensity-Matched Cohort Study
title_sort potential protective effect of hepatitis b immunity against diabetes mellitus a retrospective propensity matched cohort study
topic hepatitis B
vaccination
immunity
diabetes mellitus
prevention
url https://www.mdpi.com/2075-4418/15/13/1610
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