title: Type 2 diabetes mellitus and chronic hepatitis C: which is worse? Results of a long-term retrospective cohort study.
abstract: BACKGROUND
  The long-term outcome in patients with chronic hepatitis C and type 2 diabetes mellitus treated with interferon and ribavirin is unclear. We compared incidence of liver-related events and mortality rates between hepatitis C virus-positive patients with or without diabetes mellitus, and the incidence of diabetes-related events between diabetic patients with and without hepatitis C.
  
  
  METHODS
  Retrospective study of 309 patients with chronic hepatitis C. Incidence of liver-related events, diabetes-related events and mortality rates were assessed over a mean follow-up of 11.02±4.9 years.
  
  
  RESULTS
  50 (16%) chronic hepatitis C patients had diabetes mellitus. Diabetics showed a higher number of diabetes- and liver-related events than non-diabetics (10% vs 1.5%, p=0.006; 18% vs 5.7%, p=0.007, respectively) with a mortality of 14% vs 1.5% (p=0.0003). Baseline cirrhosis (p=0.002) and non-sustained virological response (p=0.01) were independent risk factors for liver events; diabetes mellitus (p=0.01) and hypertension (p=0.0017) were independent factors for diabetes-related events.
  
  
  CONCLUSIONS
  In patients with chronic hepatitis C, comorbidity with diabetes mellitus was associated with a higher mortality rate and incidence of liver/diabetes-related events. Independent risk factors for liver-related events were the non-response to antiviral therapy and cirrhosis at baseline.
authors.affiliation: Division of Gastroenterology, University of Turin, San Luigi Medical School, Orbassano, Italy. chiaragiordanino@libero.it
authors.forename: Chiara
authors.initials: C
authors.lastname: Giordanino
authors.forename: Simone
authors.initials: S
authors.lastname: Ceretto
authors.forename: Simona
authors.initials: S
authors.lastname: Bo
authors.forename: Antonina
authors.initials: A
authors.lastname: Smedile
authors.forename: Alessia
authors.initials: A
authors.lastname: Ciancio
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Bugianesi
authors.forename: Rinaldo
authors.initials: R
authors.lastname: Pellicano
authors.forename: Sharmila
authors.initials: S
authors.lastname: Fagoonee
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Versino
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Costa
authors.forename: Daniele
authors.initials: D
authors.lastname: Arese
authors.forename: Marco
authors.initials: M
authors.lastname: Sacco
authors.forename: Mario
authors.initials: M
authors.lastname: Rizzetto
authors.forename: Giorgio
authors.initials: G
authors.lastname: Saracco
mesh_terms: D015992:Body Mass Index; D015331:Cohort Studies; D003324:Coronary Artery Disease / Q000150:complications; D048909:Diabetes Complications; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000401:mortality*; D005260:Female; D005500:Follow-Up Studies; D019698:Hepatitis C, Chronic / Q000150:complications* / Q000401:mortality*; D006801:Humans; D006973:Hypertension / Q000150:complications; D007558:Italy / Q000453:epidemiology; D008103:Liver Cirrhosis / Q000150:complications; D017093:Liver Failure / Q000150:complications; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000150:complications; D012189:Retrospective Studies; D012307:Risk Factors