title: Hepatitis C virus infection and incident type 2 diabetes.
abstract: Although hepatitis C virus (HCV) infection is more common among adults with type 2 diabetes, it is uncertain whether HCV precedes the development of diabetes. Thus, we performed a prospective (case-cohort) analysis to examine if persons who acquired type 2 diabetes were more likely to have had antecedent HCV infection when enrolled in a community-based cohort of men and women between the ages of 44 and 65 in the United States (Atherosclerosis Risk in Communities Study [ARIC]). Among 1,084 adults free of diabetes at baseline, 548 developed diabetes over 9 years of follow-up evaluation. Incident cases of diabetes were identified by using fasting glucose and medical history and HCV antibodies were assessed at baseline. A priori, persons were categorized as low-risk or high-risk for diabetes based on their age and body mass index, factors that appeared to modify the type 2 diabetes-HCV infection incidence estimates. The overall prevalence of HCV in this population was 0.8%. Among those at high risk for diabetes, persons with HCV infection were more than 11 times as likely as those without HCV infection to develop diabetes (relative hazard, 11.58; 95% confidence interval, 1.39-96.6). Among those at low risk, no increased incidence of diabetes was detected among HCV-infected persons (relative hazard, 0.48; 95% confidence interval, 0.05-4.40). In conclusion, pre-existing HCV infection may increase the risk for type 2 diabetes in persons with recognized diabetes risk factors. Additional larger prospective evaluations are needed to confirm these preliminary findings.
authors.affiliation: Department of Epidemiology, Johns Hopkins University, Baltimore, MD, USA. shmehta@jhsph.edu
authors.forename: Shruti H
authors.initials: SH
authors.lastname: Mehta
authors.forename: Frederick L
authors.initials: FL
authors.lastname: Brancati
authors.forename: Steffanie A
authors.initials: SA
authors.lastname: Strathdee
authors.forename: James S
authors.initials: JS
authors.lastname: Pankow
authors.forename: Dale
authors.initials: D
authors.lastname: Netski
authors.forename: Josef
authors.initials: J
authors.lastname: Coresh
authors.forename: Moyses
authors.initials: M
authors.lastname: Szklo
authors.forename: David L
authors.initials: DL
authors.lastname: Thomas
mesh_terms: D017677:Age Distribution; D003920:Diabetes Mellitus / Q000453:epidemiology; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology*; D005260:Female; D006526:Hepatitis C / Q000453:epidemiology*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009765:Obesity; D015995:Prevalence; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors; D017678:Sex Distribution; D014481:United States / Q000453:epidemiology