title: HCV and diabetes mellitus: evidence for a negative association.
abstract: OBJECTIVE
  Uncontrolled, retrospective clinical studies have recently claimed that HCV infection could trigger the onset of diabetes mellitus (DM). We sought to verify the association between DM and liver diseases of different etiology, stage, and severity in a prospective study including gender- and age-matched controls.
  
  
  METHODS
  Two hundred forty-seven patients with liver cirrhosis (184 men, 116 with an associated hepatocellular carcinoma, 34% in Child-Pugh's class A) were evaluated (group 1). One hundred fifty-seven (63.5) of them were HCV positive, 38 (15.5%) HBV positive, 49 (19.8%) alcohol abusers, and three (1.2%) cryptogenic. Two control groups were also included. The first control group consisted of 138 patients with chronic hepatitis due to HCV infection (73.9%), HBV infection (15.9%), or alcohol abuse (10.2%) (group 2). The second control group included 494 patients with an acute osteoarticular trauma, age- and gender-matched with patients in group 1 (group 3).
  
  
  RESULTS
  Diabetes mellitus was present in 32.3%, 3.6%, and 9.7% of patients in groups 1, 2, and 3, respectively. When compared with controls (group 3), DM was significantly less frequent in group 2 (p < 0.004) and significantly more frequent in group 1 (p < 0.0001). The prevalence of DM was not different among patients with HCV, HBV infection, or alcohol abuse. In group 3, the prevalence of DM appeared to increase steadily with age. On the contrary, in patients with liver cirrhosis (group 1) DM was detected in about 20-30% of cases in all decades of age. In group 2, diabetics were found only in the 7th and 8th decades of life. At multivariate analysis cirrhosis and age were the only two factors independently associated with DM; odds ratios were 12.5 (95% confidence interval [C.I.], 6.74-20.4) for cirrhosis, and 1.47 for age (95% C.I. 0.39-2.55).
  
  
  CONCLUSIONS
  Our findings disprove HCV infection as a trigger factor for DM, which should not be listed among the various extrahepatic manifestations of this viral infection.
authors.affiliation: Divisione di Gastroenterologia, IRCCS, Ospedale Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Mangia
authors.forename: G
authors.initials: G
authors.lastname: Schiavone
authors.forename: G
authors.initials: G
authors.lastname: Lezzi
authors.forename: R
authors.initials: R
authors.lastname: Marmo
authors.forename: F
authors.initials: F
authors.lastname: Bruno
authors.forename: M R
authors.initials: MR
authors.lastname: Villani
authors.forename: I
authors.initials: I
authors.lastname: Cascavilla
authors.forename: L
authors.initials: L
authors.lastname: Fantasia
authors.forename: A
authors.initials: A
authors.lastname: Andriulli
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D003920:Diabetes Mellitus / Q000453:epidemiology / Q000821:virology*; D005260:Female; D006509:Hepatitis B / Q000150:complications / Q000503:physiopathology; D006526:Hepatitis C / Q000150:complications* / Q000503:physiopathology; D006801:Humans; D008108:Liver Diseases, Alcoholic / Q000150:complications; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D015995:Prevalence; D012307:Risk Factors