September 16, 2025
3 min read
Key takeaways:
- Adults with HBV immunity have 15% lower risk for diabetes than those who do not have immunity.
- The risk for diabetes decreases further for adults with higher levels of hepatitis B surface antibodies.
Adults with higher concentrations of hepatitis B surface antibodies may have decreased risk for developing diabetes, according to findings presented at the European Association for the Study of Diabetes annual meeting.
“Our findings suggest that hepatitis B immunity may be associated with a lower risk of diabetes, with stronger protection observed at higher antibody levels and among younger adults,” Nhu Quynh Phan, MD, of the international PhD program in medicine at the College of Medicine of Taipei Medical University in Taiwan and of the department of infection control at Cho Ray Hospital in Ho Chi Minh City, Vietnam, told Healio. “Clinically, this raises the possibility that the hepatitis B virus vaccine — already safe, widely available and cost-effective — could provide dual benefits: preventing HBV infection and potentially reducing diabetes risk.”
Adults who have immunity to the hepatits B virus may be less likely to develop diabetes. Image: Adobe Stock
In a study conducted under the supervision of Chiehfeng Chen, MD, PhD, professor in the department of public health at Taipei Medical University and published in Diagnostics, researchers obtained data from 582,462 adults aged 18 years and older who had hepatitis B surface antibodies measured from 2005 to 2023. Data were obtained from the Global Collaboration Network on the TriNetX platform. Propensity score matching was used to divide the participants into an immunized group with a hepatitis B surface antibody concentration of 10 mIU/mL or higher, and an unimmunized group with antibody levels below 10 mIU/mL. New-onset diabetes was defined through ICD-10 codes, the use of antihyperglycemic medications or if a person had an HbA1c of 6.5% or higher.
Nhu Quynh Phan
Adults with HBV immunity had lower risk for fulfilling any of the new-onset diabetes criteria compared with those without HBV immunity (HR = 0.85; 95% CI, 0.84-0.87). The HBV immunity group had decreased risk for having an ICD-10 diagnosis for diabetes (HR = 0.89; 95% CI, 0.87-0.91), using antihyperglycemic drugs (HR = 0.84; 95% CI, 0.83-0.86) and having an HbA1c of 6.5% or higher (HR = 0.75; 95% CI, 0.72-0.77) than adults without HBV immunity.
The risk for diabetes was reduced further with increasing hepatitis B surface antibody concentration. Adults with antibody levels of 100 mIU/mL or greater had a 19% lower risk for type 2 diabetes than those without immunity (HR = 0.81; 95% CI, 0.8-0.83) and people with hepatitis B surface antibody levels of 1,000 mIU/mL or higher had a 43% lower diabetes risk than those with antibody levels of less than 10 mIU/mL (HR = 0.57; 95% CI, 0.54-0.6).
In stratified analyses, researchers found the lowest risk for diabetes among those with HBV immunity was observed in Europe, Middle East and Africa (HR = 0.53; 95% CI, 0.48-0.58), followed by the Latin America (HR = 0.64; 95% CI, 0.6-0.68), Asia Pacific (HR = 0.73; 95% CI, 0.65-0.83) and the U.S. (HR = 0.9; 95% CI, 0.89-0.92). Among those with HBV immunity, adults aged 18 to 44 years had a greater reduction in diabetes risk (HR = 0.8; 95% CI, 0.78-0.82) than adults aged 45 to 64 years (HR = 0.89; 95% CI, 0.87-0.92) and those aged 65 years and older (HR = 0.88; 95% CI, 0.84-0.91).
“Broader HBV vaccination could serve as a unique dual-benefit strategy, not only preventing hepatitis B infection, but also potentially contributing to diabetes prevention, particularly in regions where both diseases are highly prevalent,” Phan said.
Despite the findings, Phan said more research, such as mechanistic animal models and prospective epidemiological studies, is needed to better explore the mechanisms behind the association.
“Until then, these findings should be interpreted as hypothesis-generating and supportive of continued investment in HBV immunization programs, especially in regions with high burdens of both HBV and diabetes,” Phan said.
Reference:
For more information:
Nhu Quynh Phan, MD, can be reached at d142112016@tmu.edu.tw.
Sources/Disclosures
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Phan N, et al. Oral presentation 350. Presented at: European Association for the Study of Diabetes Annual Meeting; Sept. 15-19, 2025; Vienna.
Disclosures:
The authors report no relevant financial disclosures.
