Prevalence and Risk Factors of Type 2 Diabetes Mellitus Among Hepatitis B Virus Patients: A Large Retrospective Cohort Study

Background: Hepatitis B virus (HBV) infection and type 2 diabetes mellitus (T2DM) are both major health burdens worldwide. There is a suspected link between the two conditions, but the nature of the relationship is not well understood. This study aimed to investigate the prevalence of T2DM in patients with HBV, compared to matched non-HBV patients. Methods: A retrospective cohort study was conducted using data from the Leumit-Health-Service (LHS) database, a major health insurance provider in Israel, covering the years 2000-2020. The study included patients with HBV infection and matched controls using propensity score matching. T2DM's prevalence was assessed and compared between both groups. Results: A total of 3,436 HBV carriers and 34,360 matched controls were included. T2DM's prevalence was significantly higher among HBV patients compared to the control group (22.1% vs. 19.5%; P<0.001). Through multivariate analysis, we identified age, obesity, smoking, and specific HBV-related parameters, such as chronic active disease or evidence of advanced fibrosis at presentation, as independent risk factors for T2DM in HBV patients. Conclusions: This study revealed a higher prevalence of T2DM in HBV patients compared to controls, and identified specific risk factors associated with T2DM in HBV patients. Enhanced screening and management of metabolic risk factors should be considered in this population.