大连某企业职工乙型肝炎表面抗体阳性与糖尿病发病的关系

Relationship of hepatitis virus B surface antibody positivity with the prevalence of diabetes mellitus in business employees

目的研究乙型肝炎病毒表面抗体阳性率与2型糖尿病的相关性。方法共纳入895名符合人组条件的50岁以上的健康体检者，对无糖尿病者进行75gOGTT检查。不同糖调节状态分组遵照WHO／1999标准进行。结果895名受检者HBsAb阳性率50．4％。按性别分析HBsAb阳性与DM患病率之间的相关性。发现男性HBsAb状态与IGR之间没有统计学意义，女性HBsAb阳性者DM显著低于阴性者（15．7％vs26．5％，x2=11.342，P〈0．01）。女性HBsAb阳性者的腰围、胰岛素抵抗指标及血压均低于阴性者，男性HBsAb阳性者没有发现类似趋势。结论女性HBsAb阳性个体与胰岛素抵抗相关的代谢异常更少，乙型肝炎获得性免疫可能会降低糖尿病的发病风险。

Objective To study the association of diabetes with hepatitis B surface antibody in a population more than 50 years old. Methods 895 subjects without history of diabetes and diabetic symptoms underwent 75 g OGTT. Impaired glucose regulations were defined by WHO criteria in 1999. Results The number of subjects with normal glucose tolerance （NGT）, impaired glucose tolerance （IGT）, and diabetes （DM） were 426 （47.5%）, 262 （29.2%）, and 207 （23. 1%）, respectively. There were 451 subjects with positive hepatitis virus B surface antibody （HBsAb） （50.4%）, and 444 subjects with both negative HBsAg and negative HBsAb. The HBsAb positivity was not associated with glucose tolerant states in men, while the HBsAb positive women showed significant low prevalence of DM as compared to HBsAb negative women （15. 7% vs 26. 5%,x2=11. 342,P〈0.003）. In all the selected subjects the waist circumference, glucose resistant index, and blood pressures were significant lower in HBsAb positive women than in negative women （P 〈 0. 05） , while no significant differences of those parameters were found between HBsAb positive and negative men. Similar finding to above results were noticed in NGT subgroup both in men and women. Conclusion In this small scale epidemioiogical study, HBsAb positive women exhibits less insulin resistant and might have a lower risk to develope diabetes mellitus.