New research presented at the Annual Meeting of the European Association for the Study of Diabetes (EASD) in Vienna, Austria, and published in the journal Diagnostics reveals that immunity to hepatitis B, induced by vaccination, is associated with a lower risk of developing diabetes. The study, led by Dr. Nhu-Quynh Phan from Taipei Medical University, highlights a potential dual-benefit of the hepatitis B vaccine.
The liver plays a crucial role in glucose metabolism, maintaining glucose homeostasis. Hepatitis B virus (HBV) infection can disrupt these metabolic pathways, increasing the risk of abnormal blood sugar levels and diabetes. Therefore, HBV vaccination, which provides immunity against the virus, may reduce this risk. However, the role of HBV immunity in diabetes prevention among individuals without HBV infection has been underexplored until now.
Study Design and Findings
This retrospective cohort study utilized deidentified electronic medical records from TriNetX, a global health research platform. The data was extracted from 131 healthcare organizations across various regions, including the US, Europe, the Middle East, Africa, the Asia Pacific, and Latin America. The study included adults aged 18 and older with hepatitis B surface antibody (HBsAb) results, excluding those with prior HBV infection.
Participants were classified into two groups: HBV-immunised (HBsAb ≥10 mIU/mL) and HBV-unimmunised (HBsAb <10 mIU/mL). The study encompassed 573,785 individuals in the HBV-immunised group and 318,684 in the HBV-unimmunised group. Diabetes was defined based on diagnosis, medication use, or glycated hemoglobin (HbA1c) levels of 6.5% or higher. The data was adjusted for demographics and comorbidities.
The HBV-immunised group exhibited a 15% lower risk of diabetes compared to the HBV-unimmunised group. A dose-response effect was noted, with higher HBsAb levels correlating with greater diabetes protection. Levels of 100 mIU/mL and above and 1000 mIU/mL and above were linked to 19% and 43% reductions in diabetes risk, respectively.
Age and Geographic Variations
The protective effect of HBV immunity against diabetes varied with age. Immunised individuals aged 18 to 44 years, 45 to 64 years, and 65 years and older experienced 20%, 11%, and 12% lower diabetes risks, respectively, compared to their unimmunised counterparts.
Geographical differences in the association were also significant. According to the authors, “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.” Further studies are needed to explore these variations.
Implications and Future Research
The findings suggest that the HBV vaccine could serve as a unique dual-benefit intervention, preventing both hepatitis B and diabetes. Traditional diabetes prevention strategies often involve lifestyle changes, dietary adjustments, exercise, or medication, which can be costly and require long-term commitment. In contrast, the HBV vaccine is accessible and cost-effective, particularly in regions with high prevalence of both HBV and diabetes, such as the Asia-Pacific and Africa.
The authors emphasize the need for further studies to confirm these effects and investigate the underlying mechanisms. If validated, the HBV vaccine could become a key tool in preventing both infectious and chronic diseases. The potential for such a dual-benefit intervention is particularly significant in the context of global health, where resources are often limited, and the burden of both infectious and chronic diseases is high.
This early release from the EASD 2025 meeting underscores the importance of continued research in this area, highlighting the potential for vaccines to play a broader role in chronic disease prevention.
