Study suggests link between hepatitis B immunity and lower risk of developing diabetes
• Overall HBV immunity linked with a 15% lower risk of diabetes, with higher protection in younger people and those with higher immunity shown by higher antibody levels
European Association for the Study of Diabetes
New research to be presented at this year’s Annual Meeting of the European Association for the Study of Diabetes (EASD) in Vienna, Austria (15-19 September) and published in the journal Diagnostics shows that people with hepatitis B immunity induced by vaccination have a lower risk of developing diabetes of any kind. The study is by Dr Nhu-Quynh Phan, College of Medicine, Taipei Medical University, Taipei, Taiwan, and colleagues, under the supervision of Professor Chiehfeng Chen.
The liver plays an important role in glucose metabolism, specfically maintaining the balance of glucose levels (glucose homeostasis) and it is thought HBV infection may affect liver functions and disrupt these metabolic pathways, increase the risk of abnormal blood sugar profiles and eventually increase the risk of developing diabetes, Thus, HBV vaccination, which provides immunity against HIV infection, may reduce this risk. However the role of HBV immunity in diabetes prevention among individuals without HBV infection is underexplored. In this new study, the authors evaluated whether HBV immunity reduces diabetes risk in individuals without HBV infection.
This retrospective cohort study used deidentified electronic medical records from TriNetX (a global platform that provides access to data on diagnoses, procedures, medications, laboratory results, and genomic information for biomedical and clinical research. At the time of analysis, data were extracted from 131 healthcare organizations within the Global Network, which comprises multiple Local Networks: US, Europe, Middle East, and Africa [EMEA], APAC (Asia Pacific), and LATAM (Latin America).
This study included adults (≥18 years) with HbsAb blood serology results, a marker of hepatitis B immunity, excluding those with prior HBV infection. Participants were classified as HBV-immunised (HBsAb ≥10 mIU/mL) or HBV-unimmunised (HBsAb <10 mIU/mL). Because individuals with prior infection were excluded, HBsAb positivity was attributed to vaccination, whereas negativity indicated either non-vaccination or lack of immune response after vaccination. The study inlcuded 573,785 individuals in the HBV-immunised group (HBsAb ≥ 10 mIU/mL) and 318,684 individuals in the HBV-unimmunised group (HBsAb < 10 mIU/mL).
Diabetes was defined on the basis of a diabetes diagnosis, diabetes medication use, or glycated haemoglobin (HbA1c – a measure of blood sugar control) of 6.5% or higher. The data was adjusted for demographics and comorbidities.
The authors found that the HBV-immunised group had a 15% lower diabetes risk than the HBV-unimmunised group. A dose-response effect was observed, with higher diabetes protection at higher hepatitis B antibody (HBsAb) levels. HBsAb levels of 100 mIU/mL and above and 1000 mIU/mL and above were associated with 19% and 43% reductions in diabetes risk, respectively, compared with HBsAb lower than 10 mIU/mL.
The diabetes protective effect was also associated with age. Overall, immunised individuals aged 18 to 44 years, 45 to 64 years, and 65 years and older had 20%, 11%, and 12% lower diabetes risks, respectively, compared with unimmunised individuals.
The authors discuss other important findings from the study, namely the geographical variation in the association, saying “stratified analysis revealed significant geographical differences in the protective effects of HBV immunity against diabetes. Notably, the United States—despite its wealth and advanced healthcare system—showed the least benefit in diabetes prevention associated with HBV immunity.“ The authors say that other studies are needed to clarify possible reasons for this.
Regarding the effect of ageing, the authors comment: “The association between HBV immunity and reduced diabetes risk was stronger in younger individuals compared to middle-aged and older individuals. This finding may be attributed to the natural aging of the immune system, also known as immunosenescence, which leads to diminished vaccine-induced immune responses in older adults.“
On health behaviour, they observe: „From a behavioral perspective, individuals who complete vaccination schedules may be more health-conscious and more likely to engage in healthier behaviors, such as maintaining a better diet or exercising regularly. This raises the possibility that health behavior may act as a confounder in the observed association.“
The authors conclude: “The potential for the HBV vaccine to prevent both hepatitis B and diabetes suggests that the HBV vaccine is a unique dual-benefit intervention. Traditional diabetes prevention requires lifestyle changes, dietary adjustments, exercise, or medication, which require long-term commitment and can be costly. By contrast, the HBV vaccine is accessible and cost-effective, especially in regions with a high prevalence of both HBV and diabetes, such as the Asia-Pacific region and Africa. Further studies are needed to confirm these effects and investigate the underlying mechanisms. If validated, the HBV vaccine could become a key tool for the prevention of both infectious and chronic diseases.“
*Note this is an early release from the Annual Meeting of the European Association for the Study of Diabetes (EASD 2025, Vienna, 15-19 September).
The authors declare no conflict of interest.
The press release is based on short oral presenation 350 at the Annual Meeting of the European Association for the Study of Diabetes (EASD, Vienna, 15-19 September). The full paper has been published post-submission to EASD in the journal Diagnostics. As the full paper is provided below, the abstract is not provided.
For link to full paper, which can also be used in your stories, click here
Contacts
Dr Nhu-Quynh Phan
College of Medicine, Taipei Medical University, Taipei, Taiwan, Province of China.
d142112016@tmu.edu.tw
Tony Kirby
EASD Media Centre
tony.kirby@tonykirby.com
Cell: +447834385827
Source: https://www.easd.org/home/
"Reproduced with permission - "European Association for the Study of Diabetes"
European Association for the Study of Diabetes
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