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Males seropositive for hepatitis B surface antigen are at risk of lower bone mineral density: the 2008–2010 Korea National Health and Nutrition Examination Surveys

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Abstract

Background

Hepatic osteodystrophy has been reported in patients with various chronic liver diseases, including liver cirrhosis. However, it has not been well investigated in patients with hepatitis B virus infection. The aim of this study was to investigate the association between hepatitis B surface antigen (HBsAg) seropositivity and bone mineral density (BMD) in a population representative of normal Koreans.

Methods

Subjects with both HBsAg and BMD levels examined during the 2008–2010 Korea National Health and Nutrition Examination Surveys were included. HBsAg-seropositive (+) subjects were compared with those who were HBsAg-seronegative (−). BMD was measured at the lumbar spine and femur by dual-energy X-ray absorptiometry. Multivariable logistic regression was performed for BMD .

Results

In total, 11,306 participants were included in this study, among which 423 (3.7 %) were HBsAg(+): 153 premenopausal female (3.4 %), 83 postmenopausal female (3.5 %), and 187 male (4.2 %). Multivariable logistic regression analysis adjusted for age and body mass index showed that HBsAg(+) male had significantly lower BMD of the femoral neck than HBsAg(−) male (0.810 ± 0.009 vs. 0.827 ± 0.002 g/cm2, p = 0.035). Further adjustment for waist circumference, smoking, drinking, exercise, income, occupation, and vitamin D levels showed that HBsAg(+) male had significantly lower BMD of the femur neck (0.810 ± 0.010 vs. 0.831 ± 0.002 g/cm2, p = 0.032) and lumbar spine (0.953 ± 0.011 vs. 0.974 ± 0.003 g/cm2, p = 0.049) than HBsAg(−) male.

Conclusions

HBsAg seropositivity was significantly associated with lower BMD in male. Future long-term prospective studies investigating bone turnover markers and hormones are needed to better understand the pathophysiology and clinical significance of chronic hepatitis B virus-related hepatic osteodystrophy.

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Funding

No funding was provided for this study.

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Authors and Affiliations

  1. Department of Internal Medicine, College of Medicine, The Catholic University of Korea, 222 Banpodaero, Seochogu, Seoul, 137-701, South Korea

    Myong Ki Baeg, Seung Kew Yoon, Sun-Hye Ko, Hye Jin Choi, Si Hyun Bae, Jong Young Choi & Myung-Gyu Choi

  2. Department of Biostatistics, College of Medicine, The Catholic University of Korea, 222 Banpodaero, Seochogu, Seoul, 137-701, South Korea

    Kyung-Do Han

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  1. Myong Ki Baeg
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Correspondence to Seung Kew Yoon.

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Conflict of interest

Myong Ki Baeg, Seung Kew Yoon, Sun-Hye Ko, Kyung-Do Han, Hye Jin Choi, Si Hyun Bae, Jong Young Choi, and Myung-Gyu Choi declare that they have no conflicts of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and national research committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

Informed consent

All procedures followed were in accordance with the ethical standards of the institutional review board of the Korea Centers for Disease Control and Prevention, Seoul St. Mary’s Hospital (KC15EISI0023), and the Declaration of Helsinki, as revised in 1975 and 2008. Informed consent was obtained from all patients included in the study.

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Baeg, M.K., Yoon, S.K., Ko, SH. et al. Males seropositive for hepatitis B surface antigen are at risk of lower bone mineral density: the 2008–2010 Korea National Health and Nutrition Examination Surveys. Hepatol Int 10, 470–477 (2016). https://doi.org/10.1007/s12072-015-9672-7

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