Combined effects of hepatitis B virus infection and elevated alanine aminotransferase levels on dyslipidemia

Objective. Although elevated alanine aminotransferase (ALT) levels are associated with lipid profiles, most studies do not consider the role of hepatitis B virus (HBV) infection. This study investigated the combined effects of HBV infection and elevated ALT levels on the lipid profiles of Taiwanese adults. Materials/Methods. A total of 7695 subjects were enrolled after an annual health examination. Dyslipidemia was defined as serum total cholesterol >= 200mg/dL, serum triglyceride >= 150mg/dL, high-density lipoprotein cholesterol<40mg/dL in men or <50mg/dL in women, or low-density lipoprotein cholesterol >= 130mg/dL. Multiple logistic regression analysis was performed to assess the associations between dyslipidemia, HBV infection, and elevated ALT levels. Results. Hepatitis B surface antigen positivity (HBV[+]) and elevated ALT levels (ALT[+], >= 50 U/L) were observed in 13.5% and 12.2% of the subjects, respectively. Multiple logistic analysis revealed that the HBV(+) group had a significantly lower odds ratios (ORs) for hypercholesterolemia (OR, 0.8), hypertriglyceridemia (OR, 0.7), and high low-density lipoprotein cholesterol levels (OR, 0.8); whereas, the subjects with elevated ALT levels had significantly higher ORs for all of the dyslipidemia criteria. The interaction between HBV(+) and ALT(+) had a significantly lower OR for hypertriglyceridemia (OR, 0.7). The subjects with HBV infections had a significantly lower OR for hypertriglyceridemia regardless of the ALT levels. Conclusions. HBV infection and elevated ALT levels have opposite effects on dyslipidemia, whereas their combined effects result in a significantly lower OR for hypertriglyceridemia. (c) 2013 Elsevier Inc. All rights reserved.