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Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jan 7, 2016; 22(1): 155-164
Published online Jan 7, 2016. doi: 10.3748/wjg.v22.i1.155
Association between hepatitis B and metabolic syndrome: Current state of the art
Peter Jarcuska, Sylvia Drazilova, Jan Fedacko, Daniel Pella, Martin Janicko
Peter Jarcuska, Jan Fedacko, Daniel Pella, Martin Janicko, 1st Department of Internal Medicine, University Hospital and Pavol Jozef Šafárik University in Kosice, 04001 Košice, Slovakia
Sylvia Drazilova, Department of Internal Medicine, Hospital Poprad A.S., 05845 Poprad, Slovakia
Author contributions: Janicko M and Jarcuska P specified the topic, wrote the article and led other coauthors; Drazilova S, Fedacko J and Pella D performed the search and analysis of the sources, wrote initial drafts of the chapters.
Conflict-of-interest statement: Authors report no conflict of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Correspondence to: Martin Janicko, MD, PhD, 1st Department of Internal Medicine, University Hospital and Pavol Jozef Šafárik University in Kosice, Trieda SNP 1, 04001 Košice, Slovakia.
Telephone: +42-1556403515 Fax: +42-1556403515
Received: April 28, 2015
Peer-review started: May 6, 2015
First decision: July 14, 2015
Revised: July 22, 2015
Accepted: October 13, 2015
Article in press: October 13, 2015
Published online: January 7, 2016

Chronic hepatitis B (CHB) is a global health issue that increases the risk of liver cirrhosis and hepatocellular carcinoma in infected patients. Metabolic syndrome (MetS) is a disease endemic mostly to the developed countries. It is associated with high cardiovascular mortality and morbidity, diabetes mellitus as well as cancer. In this manuscript, we systematically review the published data on the relationship between MetS and CHB infection. Multiple studies have described highly variable correlations between CHB on one hand and MetS, non-alcoholic fatty liver disease and dyslipidemia on the other. No association between CHB and diabetes mellitus or atherosclerosis has been described as of now. The presence of MetS in patients infected with hepatitis B virus increases the risk of fibrosis, cirrhosis and hepatocellular carcinoma. Appropriate lifestyle, but also pharmacological interventions are needed to prevent the development of these complications.

Keywords: Hepatitis B, Nonalcoholic fatty liver disease, Fibrosis, Cirrhosis, Metabolic syndrome, Hepatocellular carcinoma

Core tip: Currently, no clear relationship between chronic hepatitis B (CHB) and the prevalence of metabolic syndrome (MetS) could be established, but observations on large patient cohorts reveal some interesting patterns. Surprisingly, male patients with CHB may have lower prevalence of MetS than patients without CHB, but this has not been observed in females. Furthermore, CHB is probably not associated with higher risk of type 2 diabetes mellitus or atherosclerosis. Regarding the clinical outcomes, available data do not sufficiently reveal all of the possible interactions between MetS, its individual components and CHB.