Further evidence for an association between non-insulin-dependent diabetes mellitus and chronic hepatitis C virus infection.
Non-insulin-dependent diabetes mellitus (NIDDM) may be associated with chronic hepatitis C virus (HCV) infection. This was studied further in two parts. First, 1,151 patients with HCV-related cirrhosis and 181 patients with hepatitis B virus (HBV)-related cirrhosis, well matched for age, sex, and severity of cirrhosis, were reviewed retrospectively. The prevalence of diabetes mellitus was higher in HCV-related cirrhosis (23.6%) than in HBV-related cirrhosis (9.4%; odds ratio [OR], 2.78; 95% confidence interval [CI], 1.6-4.79; P =.0002). The prevalence of diabetes mellitus was associated closely with the Child-Pugh score (OR, 3.83; 95% CI, 2. 38-6.17; P <.0001) and increasing age (OR, 1.02; 95% CI, 1.00-1.03; P =.0117). Second, 235 patients with biopsy confirmed chronic HBV or HCV underwent an oral glucose tolerance test. Only 1 of 70 patients with chronic viral hepatitis without cirrhosis was diabetic. However, 31 of 127 patients with HCV-related cirrhosis (24.4%) were diabetic compared with 3 of 38 patients with HBV-related cirrhosis (7.9%, P =.0477). The major variables associated with NIDDM were cirrhosis (OR, 14.39; 95% CI, 1.91-108; P =.0096) and male sex (OR, 4.64; 95% CI, 1. 32-16.18; P =.0161). Fasting insulin levels in 30 patients with HCV-related cirrhosis and diabetes mellitus were elevated significantly, which was consistent with insulin resistance. However, acute insulin responsiveness was reduced in all patients with HCV infection and diabetes suggesting concomitant B-cell dysfunction. This study confirms an association between HCV and NIDDM.
Caronia
S
S
Istituto di Clinica Medica, Universita' Degli Studi di Palermo; Divisione di Medicina Interna, Ospedale "V Cervello," Palermo, Sicily.
Taylor
K
K
Pagliaro
L
L
Carr
C
C
Palazzo
U
U
Petrik
J
J
O'Rahilly
S
S
Shore
S
S
Tom
B D
BD
Alexander
G J
GJ
D000328:Adult; D000368:Aged; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D005260:Female; D018067:Flaviviridae; D006509:Hepatitis B / Q000150:complications; D019698:Hepatitis C, Chronic / Q000150:complications*; D006525:Hepatitis, Viral, Human / Q000150:complications; D006801:Humans; D007328:Insulin / Q000097:blood; D008103:Liver Cirrhosis / Q000097:blood / Q000821:virology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012189:Retrospective Studies
D007328:Insulin