Association of chronic viral hepatitis B with insulin resistance

Table 1 Baseline characteristics of study subjects

Variables	Men	Women
	(n = 3851)	(n = 4029)
Age (yr)	48.9 ± 10.7	48.6 ± 10.4
BMI (kg/m2)	24.5 ± 2.8	23.5 ± 2.9
Abdominal circumference (cm)	86.5 ± 7.4	79.2 ± 8.4
Percentage body fat (%)	22.7 ± 5.1	30.1 ± 5.7
Systolic BP (mmHg)	126.3 ± 15.3	122.3 ± 15.4
AST (IU/L)	23.8 ± 8.6	20.9 ± 10.5
ALT (IU/L)	26.8 ± 16.6	19.0 ± 11.5
GGT (IU/L)	38.0 ± 20.1	20.0 ± 12.6
Fasting plasma glucose (mg/dL)	91.6 ± 14.7	88.3 ± 14.1
Fasting insulin (μU/mL)	5.48 ± 3.49	4.64 ± 2.78
Total cholesterol (mg/dL)	196.3 ± 33.3	195.8 ± 35.2
Triglycerides (mg/dL)	138.0 ± 80.9	103.8 ± 63.6
HDL-cholesterol (mg/dL)	50.8 ± 12.5	59.8 ± 14.1
LDL-cholesterol (mg/dL)	124.8 ± 29.5	121.0 ± 31.8
high-sensitivity CRP (mg/dL)	0.15 ± 0.47	0.11 ± 0.37
TSH (μU/mL)	1.79 ± 1.79	2.29 ± 2.15
Uric acid (mg/dL)	5.88 ± 1.25	4.20 ± 0.91

Differences between men and women were statistically significant except for age and total cholesterol (P < 0.05 by t test). BMI: Body mass index; BP: Blood pressure; AST: Aspartate transferase; ALT: Alanine transferase; GGT: Gamma-glutamyl transferase; HDL: High-density lipoprotein; LDL: Low-density lipoprotein; CRP: C-reactive protein; TSH: Thyroid stimulating hormone.

Table 2 Means and frequencies of metabolic risk factors associated with hepatitis B virus status in men and women (mean ± SD)

Variables	Negative (n = 1292)	Recovery from hepatitis B (n = 1956)	Chronic hepatitis B (n = 603)	P value1
Hepatitis B virus status in men
Age (yr)	44.4 ± 11.7	51.4 ± 9.4	50.8 ± 10.7	0.000
Body mass index (kg/m2)	24.5 ± 2.9	24.5 ± 2.7	24.7 ± 2.9	0.493
Waist circumference (cm)	86.0 ± 7.7	86.5 ± 7.0	87.3 ± 7.8	0.004
Percentage body fat (%)	22.5 ± 5.7	22.8 ± 4.6	23.0 ± 5.0	0.094
Systolic blood pressure (mmHg)	126.4 ± 15.5	126.3 ± 15.0	126.1 ± 15.6	0.922
Total cholesterol (mg/dL)	196.0 ± 33.2	196.8 ± 33.1	195.5 ± 34.5	0.680
Triglyceride (mg/dL)	142.8 ± 84.5	135.6 ± 79.2	135.2 ± 78.2	0.029
HDL-cholesterol (mg/dL)	51.0 ± 12.7	50.9 ± 12.8	50.4 ± 11.4	0.602
Cystatin C (mg/L)	0.96 ± 0.15	0.98 ± 0.16	1.02 ± 0.22	0.000
Fasting glucose (mg/dL)	90.7 ± 15.3	92.1 ± 14.4	91.9 ± 14.4	0.039
Fasting insulin (μU/mL)	5.47 ± 3.38	5.29 ± 3.10	6.12 ± 4.62	0.000
HOMA index	1.24 ± 0.86	1.22 ± 0.80	1.43 ± 1.24	0.000
QUICKI index	0.386 ± 0.065	0.386 ± 0.044	0.385 ± 0.134	0.922
Mffm index	8.41 ± 2.43	8.58 ± 2.31	8.39 ± 2.63	0.072
Hepatitis B virus status in women
Age (yr)	45.9 ± 10.7	50.9 ± 9.3	51.6 ± 10.3	0.000
Body mass index (kg/m2)	23.2 ± 3.0	23.7 ± 2.7	24.0 ± 2.9	0.000
Waist circumference (cm)	78.3 ± 8.6	79.8 ± 8.0	80.5 ± 8.5	0.000
Percentage body fat (%)	29.6 ± 6.8	30.4 ± 4.6	31.0 ± 4.9	0.000
Systolic blood pressure (mmHg)	121.3 ± 15.4	123.0 ± 15.5	124.5 ± 14.3	0.000
Total cholesterol (mg/dL)	193.3 ± 35.4	197.9 ± 35.0	198.1 ± 34.3	0.000
Triglyceride (mg/dL)	102.0 ± 63.5	106.4 ± 66.2	100.3 ± 47.5	0.061
LDL-cholesterol (mg/dL)	118.3 ± 31.6	123.2 ± 31.8	123.7 ± 31.7	0.000
Cystatin C (mg/L)	0.84 ± 0.15	0.87 ± 0.15	0.90 ± 0.16	0.000
Fasting glucose (mg/dL)	88.0 ± 14.6	88.7 ± 13.7	88.3 ± 12.9	0.357
Fasting insulin (μU/mL)	4.57 ± 2.82	4.62 ± 2.67	5.06 ± 3.10	0.010
HOMA index	1.02 ± 0.76	1.03 ± 0.67	1.13 ± 0.87	0.033
QUICKI index	0.401 ± 0.056	0.398 ± 0.051	0.392 ± 0.045	0.013
Mffm index	9.77 ± 2.62	9.58 ± 2.53	9.36 ± 2.25	0.006

¹Analysis of variance except triglyceride (Kruskal-Wallis test). HDL: High-density lipoprotein; LDL: Low-density lipoprotein; HOMA: Homeostasis model assessment; QUICKI: Quantitative insulin check index.

Table 3 Partial correlation coefficients of insulin sensitivity index to metabolic parameters after adjusting for age, gender, and alcohol consumption

	BMI	WC	BFP	SBP	TC	TG	HDL-C	Cys-C	Uric acid
FPG	0.150	0.151	0.114	0.138	0.087	0.141	-0.102	-0.108	-0.010
Insulin	0.395	0.368	0.313	0.196	0.132	0.293	-0.206	0.105	0.168
HOMA index	0.378	0.356	0.296	0.202	0.134	0.292	-0.202	0.069	0.142
QUICKI index	-0.254	-0.243	-0.217	-0.132	-0.106	-0.205	0.164	-0.044	-0.096
Mffm index	-0.374	-0.366	-0.318	-0.199	-0.258	-0.628	0.386	-0.116	-0.203

BMI: Body mass index; WC: Waist circumference; BFP: Percent of body fat; SBP: Systolic blood pressure; TC: Total cholesterol; TG: Triglyceride; HDL: High-density lipoprotein; Cys-C: Cystatin-C; FPG: Fasting plasma glucose; HOMA: Homeostasis model assessment; QUICKI: Quantitative insulin check index. All correlation coefficients are statistically significant (P < 0.001).

Table 4 Logistic regression analysis with insulin resistance as a dependent variable

Variables	Insulin resistance
	HOMA index criteria			QUICKI criteria
	β	SE	Odds ratio (95% CI)	β	SE	Odds ratio (95% CI)
Age (yr)	0.009	0.005	1.009 (0.999-1.019)	0.016	0.006	1.016 (1.005-1.028)
Gender
Men	0.487	0.109	1.627 (1.314-2.015)	0.452	0.131	1.571 (1.215-2.031)
Women			1.000			1.000
Body mass index (kg/m2)	0.316	0.017	1.372 (1.328-1.417)	0.347	0.020	1.746 (1.663-1.833)
Alcohol consumption (kcal)	0.000	0.000	1.000 (0.999-1.000)	0.000	0.000	1.000 (0.999-1.000)
Hepatitis B virus status
Negative			1.000			1.000
Recovery from hepatitis B	-0.027	0.112	0.974 (0.782-1.212)	-0.075	0.135	0.928 (0.712-1.210)
Chronic hepatitis B	0.428	0.143	1.534 (1.158-2.031)	0.449	0.169	1.566 (1.124-2.182)

HOMA: Homeostasis model assessment; QUICKI: Quantitative insulin check index.