title: Hepatitis C infection and risk of diabetes: a systematic review and meta-analysis.
abstract: OBJECTIVE
  Several studies found hepatitis C (HCV) increases risk of Type II diabetes mellitus (DM). However, others found no or only sub-group specific excess risk. We performed meta-analyses to examine whether HCV infection does increase DM risk in comparison to the general population and in other sub-groups with increased liver disease rates including with hepatitis B (HBV).
  
  
  METHODS
  We followed standard guidelines for performance of meta-analyses. Two independent investigators identified eligible studies through structured keyword searches in relevant databases including PubMed.
  
  
  RESULTS
  We identified 34 eligible studies. Pooled estimators indicated significant DM risk in HCV-infected cases in comparison to non-infected controls in both retrospective (OR(adjusted)=1.68, 95% CI 1.15-2.20) and prospective studies (HR(adjusted)=1.67, 95% CI 1.28-2.06). Excess risk was also observed in comparison to HBV-infected controls (OR(adjusted)=1.80, 95% CI 1.20-1.40) with suggestive excess observed in HCV+/HIV+ cases in comparison to HIV+ controls (OR(unadjusted)=1.82, 95% CI 1.27-2.38).
  
  
  CONCLUSIONS
  Our finding of excess DM risk with HCV infection in comparison to non-infected controls is strengthened by consistency of results from both prospective and retrospective studies. The excess risk observed in comparison to HBV-infected controls suggests a potential direct viral role in promoting DM risk, but this needs to be further examined.
authors.affiliation: Section of Gastroenterology and Hepatology, Baylor College of Medicine, Michael E. DeBakey VA Medical Center, Houston, TX 77030, USA.
authors.forename: Donna L
authors.initials: DL
authors.lastname: White
authors.forename: Vlad
authors.initials: V
authors.lastname: Ratziu
authors.forename: Hashem B
authors.initials: HB
authors.lastname: El-Serag
mesh_terms: D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D003920:Diabetes Mellitus / Q000209:etiology*; D005260:Female; D015658:HIV Infections / Q000150:complications; D006509:Hepatitis B / Q000150:complications; D006526:Hepatitis C / Q000150:complications*; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011446:Prospective Studies; D012189:Retrospective Studies; D012307:Risk Factors