Association of patients with chronic HBV and HCV with metabolic syndrome

Hepatitis B and hepatitis C, both of which are widely seen globally, are major causes of chronic liver disease. They cause chronic liver disease and recently a relation between chronic hepatitis due to HBV and HCV, and fatty liver has been found. This suggested that hepatitis virus might cause metabolic changes in addition to causing hepatitis. Since fatty liver has been suggested as a hepatic manifestation of Metabolic Syndrome (MS) in various literature, the association of HBV and HCV with MS has become striking. We aimed to evaluate the association of chronic hepatitis B and hepatitis C with MS and its components. Sixty-two patients with chronic hepatitis C (male/female ratio: 22/40) and 358 patients with chronic hepatitis B (male/female ratio: 219/139) were included in the study. The demographic characteristics of the patients were recorded and subsequently serological and biochemical tests were performed. Diagnosis of MS was evaluated according to the criteria of the International Diabetes Federation. Insulin resistance (IR) was defined using the Homeostasis model assessment (HOMA) index. Mean age in the overall series was 43,43±13,42 years and mean BMI was 27.69±4.96 (p<0.05). Twenty-four out of 62 patients with HCV (38.7%) and 97 out of 358 patients with HBV (27.1%) were diagnosed with MS. The difference between the two groups was not statistically significant (p=0,086). Diabetes was present in 11 (17.7%), and 32 (8.9%) of patients with HCV and HBV, respectively, showing no difference between the two groups (p=0.059). IR was present in 207 patients (49.3%). The number of patients with IR was 31 (50%) in patients with hepatitis C and while 176 (49.2%) in patients with hepatitis B, no difference was shown between the two groups (p= 0,987). In addition, the rate of presence of diabetes and IR was also similar in patients with HCV and HBV with MS (p=0.857). Among our patient population we found the rate of fatty liver at 38.3%. Fatty liver was also present in 24 (38.7%) and 137 (38.3%) patients with HCV and HBV, respectively with no difference between the two groups (p=0.939). Also, there was no difference in liver steatosis of the patients with HCV and HBV with the diagnosis of MS (p=0.933). In conclusion, it may be suggested that chronic HBV infection also plays a role in liver steatosis as is HCV infection, and thus an infection, presenting a risk for MS. It can therefore be postulated that HBV, like HCV, also carries all the risks caused by MS and liver steatosis. Nevertheless, more advanced studies on this issue are needed.