Protective Effect of Hepatitis B against Metabolic Syndrome in Patients with Nonalcoholic Fatty Liver Disease but Not in Normal Individuals

Chun Pei, Chung Ze Wu, Chang Hsun Hsieh, Jin Biou Chang, Yao Jen Liang, Yen Lin Chen, Dee Pei, Jiunn Diann Lin

Research output: Contribution to journalArticlepeer-review


Background: Both hepatitis B (HB) and nonalcoholic fatty liver disease (NAFLD) are related to metabolic syndrome (MetS); however, this relationship remains controversial. In this study, we determined the effects of NAFLD and HB infection on the risk of MetS among elderly individuals. Methods: In total, 24,500 individuals aged >65 years were enrolled; they were classified into four groups: normal individuals (N), patients with only HB infection without abnormal echogenicity (HB-alone), patients with only abnormal echogenicity or fatty liver alone (FL-alone), and patients with both HB infection and abnormal echogenicity (HB-FL). Results: After adjustment for age, compared with group N, men and women with NAFLD (FL-alone and HB-FL) had a significantly higher risk of MetS, whereas no significant difference was observed in the incidence of MetS between groups HB-alone and N. However, group HB-FL had a lower risk of MetS than did group FL-alone. HB infection (HB-alone and HB-FL) was associated with a lower risk of high triglycerides (TGs) and fasting plasma glucose (FPG) than HB infection absence (groups N and FL-alone) in men and women. Lower risk of TG derangement was observed in group HB-alone than in group N. In addition, both men and women in group HB-FL had a lower risk of TG and FPG abnormalities than in group FL-alone, whereas a decrease in incidence of high waist circumference and blood pressure was observed only in men. Conclusion: HB infection protects against MetS development, only in patients with HB infection and NAFLD, but not in normal individuals. Additional studies are warranted to clarify the pathogenesis.

Original languageEnglish
Pages (from-to)458-464
Number of pages7
JournalMetabolic Syndrome and Related Disorders
Issue number9
Publication statusPublished - Nov 2019


  • fasting plasma glucose
  • hepatitis B
  • metabolic syndrome
  • nonalcoholic fatty liver disease
  • triglyceride

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism


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