Risk factors for the development of diabetes mellitus in chronic hepatitis C virus genotype 4 infection.
OBJECTIVE
A high occurrence of type 2 diabetes (T2D) in patients with chronic hepatitis C virus (HCV) infection has been reported in Kuwait and other countries. However, HCV genotype 4 has been underrepresented in all previous studies. Our aim was to investigate the viral and host risk factors associated with the development of T2D in patients with chronic hepatitis C genotype 4 infection in the absence of liver fibrosis and steatosis.


METHODS
The study population consisted of 181 HCV-positive patients and 170 control HCV-negative patients with T2D.


RESULTS
The prevalence of HCV-patients with T2D was 39.8%. There was no significant association of T2D with gender, nationality, obesity, HCV viral load, or antiviral therapy. Older age (>or= 50 years) and family history of diabetes were the only independent risk factor for T2D in HCV patients. However, the median age and the prevalence of obesity in HCV-positive patients with T2D were significantly lower than those in diabetic HCV-negative patients. By following-up HCV-patients receiving antiviral drugs, a significant decrease of fasting plasma glucose and glycosylated hemoglobin levels was observed in diabetic patients who achieved a sustained viral response (SVR).


CONCLUSIONS
The risk factors associated with the development of T2D in the general population cannot alone account for the high prevalence of T2D obtained in chronic HCV genotype 4 infection. In the absence of liver fibrosis and steatosis, the improvement in glycemic control obtained in SVR patients may imply direct involvement of HCV in the development of T2D.
Chehadeh
Wassim
W
Department of Microbiology, Faculty of Medicine, Kuwait University, Safat. wchehadeh@hsc.edu.kw
Abdella
Nabila
N
Ben-Nakhi
Abdullah
A
Al-Arouj
Monira
M
Al-Nakib
Widad
W
D000328:Adult; D000367:Age Factors; D000368:Aged; D000998:Antiviral Agents / Q000627:therapeutic use; D001786:Blood Glucose / Q000187:drug effects; D015992:Body Mass Index; D016022:Case-Control Studies; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000208:ethnology / Q000235:genetics / Q000821:virology*; D004534:Egypt / Q000208:ethnology; D020022:Genetic Predisposition to Disease; D005838:Genotype; D006442:Glycated Hemoglobin / Q000378:metabolism; D016174:Hepacivirus / Q000235:genetics*; D019698:Hepatitis C, Chronic / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy / Q000208:ethnology; D006801:Humans; D007730:Kuwait / Q000453:epidemiology; D016015:Logistic Models; D008875:Middle Aged; D016017:Odds Ratio; D010375:Pedigree; D015995:Prevalence; D012367:RNA, Viral / Q000097:blood; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D019562:Viral Load; D055815:Young Adult
D000998:Antiviral Agents; D001786:Blood Glucose; D006442:Glycated Hemoglobin; D012367:RNA, Viral; C517652:hemoglobin A1c protein, human