Hepatitis C Virus Infection and the Development of Type 2 Diabetes in a Community-based Longitudinal Study

Abstract

The temporal relation of hepatitis C virus (HCV) infection to the development of type 2 diabetes remains unknown. The authors followed 4,958 persons aged > or =40 years without diabetes (3,486 seronegative, 812 anti-HCV+, 116 with hepatitis B virus/HCV coinfection, and 544 hepatitis B surface antigen (HBsAg)+) from a community-wide cohort in southern Taiwan for 7 years (1997-2003) to study the risk of diabetes associated with HCV infection. A total of 474 participants developed diabetes. The 7-year cumulative incidence was 7.5% for HBsAg+, 8.6% for seronegative, 14.3% for anti-HCV+, and 14.7% for coinfected participants. Compared with HCV- persons, HCV+ persons had a higher cumulative incidence of diabetes (log-rank test, p < 0.0001). A multivariate Cox proportional hazards model showed that anti-HCV+ (hazard ratio = 1.7, 95% confidence interval: 1.3, 2.1), coinfection (hazard ratio = 1.7), overweight, obesity, and increasing age were significantly associated with diabetes (p < 0.05). Gender, educational level, HBsAg+ status, alcohol consumption, and smoking were not significant. After stratification by age and body mass index, the risk ratio for diabetes in anti-HCV+ participants increased when age decreased and body mass index levels increased (p < 0.001). Results show that HCV infection is an independent predictor of diabetes, especially for anti-HCV+ persons who are younger or have a higher body mass index.

To Study the Prevalence of Impaired Glucose Tolerance in Patients with Hepatitis C Virus Related Chronic Liver Disease

“…Mehta et al, in their study did conclude that amongst patients with HCV related liver disease, the incidence of DM was higher in those who were older and those who had a high BMI [23]. A study conducted in Taiwan by Wang et al, showed that the risk ratio for diabetes in anti-HCV positive patients increased when BMI levels increased [26]. Our study also revealed that increase in the BMI increases the prevalence of impaired glucose tolerance.…”

“…It was found that the maximum number of patients with impaired glucose tolerance were in the age group 60-69 y (13 patients). Mason et al, [13] and Wang et al, [24,26] also studied correlation of gender with IGT/DM and found that gender did not have significant influence on the development of diabetes. However, our study revealed that females did have a significantly higher prevalence of impaired glucose tolerance (14 out of 22 females v/s 26 out of 78 males).…”

Insulin resistance in non-diabetic patients with chronic hepatitis C: what does it mean?

“…Epidemiological studies support an association between chronic HCV hepatitis and type DM2 as the primary predisposing factor being insulin resistant (IR) (24)(25)(26)(27). According to Mehta and cols.…”

“…(2000), subjects who are more than 40 years old and have anti-HCV antibodies have a 3.77 fold higher risk of developing DM2, compared with those who were anti-HCV negative, matched for gender, BMI and ethnic background (27). Although liver cirrhosis (regardless of etiology) has been associated with the development of IR and DM2, chronic HCV infection is reported to be more strongly related with the development of IR than chronic HBV hepatitis (26). In our study, from 82 patients, 22 (27%) had serum HOMA-IR levels greater than 2.5, which is consistent with IR diagnosis.…”

Profiles of Liver Function Tests among Type 2 Diabetic Patients Who are Receiving Different Anti-Diabetic Drugs Attending Tikur Anbessa Specialized Hospitals

“…Patients whose fasting blood glucose levels were >115 mg/dl were selected. 70 patients were recruited for study group and 35 patients were recruited for control group, in the ratio of 2:1 [51][52][53][54][55][56][57][58][59][60].…”