Hepatitis C virus infection and the development of type 2 diabetes in a community-based longitudinal study.
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.
Wang
Chong-Shan
CS
Community Medicine Research Center and Institute of Public Health, National Yang-Ming University, Taipei, Taiwan.
Wang
Shan-Tair
ST
Yao
Wei-Jen
WJ
Chang
Ting-Tsung
TT
Chou
Pesus
P
D000328:Adult; D003924:Diabetes Mellitus, Type 2 / Q000209:etiology*; D005260:Female; D006509:Hepatitis B / Q000150:complications* / Q000453:epidemiology; D006514:Hepatitis B Surface Antigens / Q000097:blood; D006526:Hepatitis C / Q000150:complications*; D006801:Humans; D015994:Incidence; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications; D016016:Proportional Hazards Models; D012306:Risk; D013624:Taiwan / Q000453:epidemiology
D006514:Hepatitis B Surface Antigens