Associations between human cytomegalovirus infection and type 2 diabetes mellitus: a systematic review and meta-analysis

Abstract

ObjectiveMultiple studies have reported a potential contribution of human cytomegalovirus (HCMV) to the pathogenesis of type 1 diabetes and post-transplantation diabetes. However, the association between HCMV and type 2 diabetes mellitus (T2DM) remains unclear. In this paper, we employ the meta-analysis approach to investigate the potential correlation between HCMV infection and T2DM.MethodThe data of our study were collected from PubMed, Embase, Web of Science, Cochrane Library, China National Knowledge Infrastructure and WAN FANG databases from inception to November 2022. Using the Review Manager V.5.4 software, the meta-analysis was performed.ResultsA total of 18 139 patients from 22 studies were included in our analysis. In the Asian subgroup, the patients with T2DM group had a significantly higher frequency of HCMV infection and older age compared with the healthy group. In the European, the frequency of HCMV infection in the T2DM was lower than the healthy group, although this difference was not statistically significant. After adjusting for demographic factors, the adjusted OR of T2DM for risk of by HCMV status was not found to be significant (adjusted OR=1.19, 95% CI=0.88 to 1.62, p>0.05). Additionally, T2DM with vasculopathy had a significantly higher rate of HCMV infection compared with those without vasculopathy (OR=1.87, 95% CI=1.24 to 2.83, p<0.05). Among T2DM with HCMV infection, there were significant increases in fasting blood glucose levels and the proportion of CD8+ T lymphocytes. Conversely, fasting blood insulin levels, the proportion of CD4+ T lymphocyte and the CD4+/CD8+ ratio were significantly decreased compared with the healthy group.ConclusionAt present, the available evidence does not provide a clear understanding of whether there is a significant association between T2DM and HCMV infection. Additionally, T2DM with HCMV infection exhibited significantly worse blood glucose regulation and immune markers, as well as a higher frequency of vasculopathy.PROSPERO registration numberCRD42022342066.

An analysis of risk factors for spontaneously occurring type 2 diabetes mellitus in rhesus macaques (Macaca mulatta)

“…7 Recently, cytomegalovirus has been shown to be related to T2D onset, although some evidence suggests this may not be the case for all human populations. 8 In one study, 576 adult patients with CMV disease were followed for 5 years along with 2880 controls; neither group had evidence of T2D at the outset. Over the 5-year follow-up, new-onset cases were significantly higher in the group with CMV disease compared to case controls.…”

Human Vascularized Macrophage-Islet Organoids to Model Immune-Mediated Pancreatic β cell Pyroptosis upon Viral Infection

“…Studies reported a heightened T1D and type 2 diabetes (T2D) incidence rates after the beginning of pandemic, surpassing pre-pandemic period 7,8,9 . In addition to SARS-CoV-2, a number of studies suggests the correlation between viral infections and T1D 10 , including enteroviruses 11 , such as coxsackievirus B 12,13 , as well as rotavirus 14 , mumps virus 15 , and cytomegalovirus 16 . Coxsackievirus B4 (CVB4), a positivesense single-stranded RNA virus, isolated from newly diagnosed T1D patients could infect and induce destruction of human islet cells in vitro 17 .…”