Evidence for a link between hepatitis C virus infection and diabetes mellitus in a cirrhotic population

Allison, Michael; Wreghitt, Tim; Palmer, Chris; Alexander, Graeme

doi:10.1016/s0168-8278(05)80631-2

Cited by 427 publications

(314 citation statements)

References 6 publications

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“…It is now over 10 years since an association between HCV and diabetes was first described by Allison et al [16] who noted that people with cirrhosis and HCV had T2DM more commonly than those with cirrhosis from other causes. A subsequent study of cirrhotic patients confirmed that T2DM was present in 21% of patients with cirrhosis due to CHC but was present in only 12% of patients with cirrhosis and chronic hepatitis B (CHB) [17] .…”

Section: Chc and T2dmmentioning

confidence: 99%

Molecular mechanisms of insulin resistance in chronic hepatitis C

Douglas

George²

2009

WJG

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It is now widely recognized that chronic hepatitis C (CHC) is associated with insulin resistance (IR) and type 2 diabetes, so can be considered a metabolic disease. IR is most strongly associated with hepatitis C virus (HCV) genotype 1, in contrast to hepatic steatosis, which is associated with genotype 3 infection. Apart from the well-described complications of diabetes, IR in CHC predicts faster progression to fibrosis and cirrhosis that may culminate in liver failure and hepatocellular carcinoma. More recently, it has been recognized that IR in CHC predicts a poor response to antiviral therapy. The molecular mechanisms for the association between IR and HCV infection are not well defined. This review will elaborate on the clinical associations between CHC and IR and summarize current knowledge regarding the molecular mechanisms that potentially mediate HCV-associated IR.

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Section: Chc and T2dmmentioning

confidence: 99%

Molecular mechanisms of insulin resistance in chronic hepatitis C

Douglas

George²

2009

WJG

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“…Although a body of experimental data from in vitro cell cultures and in vivo transgenic mice support the existence of interaction between HCV and host metabolic factors, the results from clinical and epidemiological studies remained controversial [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16]. The inconsistencies may be due to small sample size, the selection of patients only from hospitals or limited to hepatitis patients with cirrhosis, with diabetes, or to post-liver-transplant.…”

Section: Introductionmentioning

confidence: 99%

Metabolic profiles in patients with chronic hepatitis C: a case–control study

Hsu

Liu

et al. 2008

Hepatol Int

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BackgroundThe clinical implications of metabolic profiles in patients with chronic hepatitis C remain controversial. To study the association of metabolic abnormalities with chronic hepatitis C, we conducted a case-control study with special emphasis on serum lipid pattern, fasting blood glucose, and adiponectin. Methods We enrolled 500 patients with chronic hepatitis C and 536 sex and age-matched controls. Unadjusted and adjusted associations of demographic and metabolic variables were estimated. Results Chronic hepatitis C patients had higher alanine aminotransferase (ALT) and high-density lipoprotein-cholesterol levels, but lower total cholesterol (TC), triglyceride (TG), and low-density lipoprotein-cholesterol levels than controls. Stratifying ALT level according to its upper limit of normal, HCV infection was associated with younger age, female gender, and higher TC levels in chronic hepatitis C patients with normal ALT levels, but with lower TC and lower TG levels in those with abnormal ALT levels. By using multiple linear regression analyses for subjects with available adiponectin data, presence of HCV infection was independently associated with higher serum adiponectin levels. Conclusions Metabolic profiles of chronic hepatitis C patients are affected by age, gender, serum adiponectin, and ALT levels. Further longitudinal studies are needed to clarify the complex interplay between HCV infection and metabolic profiles.

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“…Hence, glucose intolerance is common in patients with liver cirrhosis of whatever aetiology, and around 20% of cirrhotic patients have overt diabetes [3]. Chronic hepatitis C virus (HCV) infection is well known to be associated with increased risk of type 2 diabetes [4][5][6][7][8][9][10]. This risk association is independent of the presence of cirrhosis [11,12], and has been hypothesised to be mediated through insulin resistance and chronic inflammation [12].…”

Section: Introductionmentioning

confidence: 99%

Chronic hepatitis B viral infection independently predicts renal outcome in type 2 diabetic patients

et al. 2006

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Aims/hypothesis: We examined the association between chronic hepatitis B virus (HBV) infection and clinical outcomes in a consecutive cohort of Chinese patients with type 2 diabetes. Subjects, materials and methods: Between 1995 and 1999, 2,838 type 2 diabetes patients underwent comprehensive assessments and blood screening for hepatitis B surface antigen (HBsAg). The risk of occurrence of cardiovascular events and end-stage renal disease (defined as need for dialysis, doubling of serum creatinine or serum creatinine ≥500 μmol/l) was compared between HBsAg-positive and HBsAg-negative groups. Results: At baseline, HBV-infected patients (n=286, 10.1%) were younger (51.0±11.5 vs 53.7±12.7 years, p=0.004), had earlier onset of diabetes (51.0±11.5 vs 53.7±12.7 years, p=0.001) and a higher frequency of retinopathy (28 vs 22%, p=0.03) than non-HBV-infected patients. After a median follow-up of 3.5 years (interquartile range: 1.7-5.9 years) and adjustment of age, glycaemic control and other potential confounding factors, HBV-infected patients were more likely to develop end-stage renal disease than non-HBV infected patients (8.7 vs 6.4%) with a hazard ratio of 4.5 (95% CI 1.1-18.6). The difference in the frequency of cardiovascular endpoints was not statistically significant. Conclusions: In Chinese type 2 diabetes patients, chronic HBV infection was associated with increased risk of end-stage renal disease, and this was independent of other potential confounding factors. Early identification of HBV status and close surveillance of renal function are important in patients with type 2 diabetes who are living in areas where HBV is endemic or who are at risk of chronic HBV infection.

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Evidence for a link between hepatitis C virus infection and diabetes mellitus in a cirrhotic population

Cited by 427 publications

References 6 publications

Molecular mechanisms of insulin resistance in chronic hepatitis C

Molecular mechanisms of insulin resistance in chronic hepatitis C

Metabolic profiles in patients with chronic hepatitis C: a case–control study

Chronic hepatitis B viral infection independently predicts renal outcome in type 2 diabetic patients

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