Risk of microangiopathy in type 2 diabetes mellitus patients with or without chronic hepatitis C: Results of a retrospective long-term controlled cohort study.
BACKGROUND
Patients with chronic hepatitis C have an increased risk of diabetes mellitus but the type and risk of developing diabetes-related complications have not yet been evaluated.


METHODS
In order to compare the incidence of diabetic microangiopathy in patients with new onset diabetes without microangiopathy we recruited 54 hepatitis C virus (HCV)-positive and 119 HCV-negative patients from January 2005 to December 2006. All patients were followed-up every 6 months for liver and diabetic complications and incidence of cardiovascular diseases up to December 2012 when data were retrospectively analyzed.


RESULTS
The two cohorts were comparable at enrolment except for mean body mass index, obesity rate and family history of diabetes (p=0.007). After 7.2 years of follow-up, 13 HCV-positive (24.1%) and 37 HCV-negative patients (31%) showed at least one microangiopathic complication (p=0.34); 5 HCV-positive (9.3%) and 13 HCV-negative patients (10.8%) reported cardiovascular diseases (p=0.2); 14 HCV-positive (24.5%) compared to 0 HCV-negative patients developed liver-related complications (p=0.0003). One HCV-positive patient died due to liver cancer, 1 HCV-negative patient died from myocardial infarction (p=0.3). Increasing age (HR=1.04, 95% CI: 1.00-1.07, p=0.04) and smoking (HR=2.94, 95% CI: 1.06-8.17, p=0.04) were positively associated to diabetic complications.


CONCLUSIONS
Incidence of microangiopathy is not significantly different in diabetics with or without chronic hepatitis C.
Gastroenterology Unit, Department of Oncology, University of Turin, Turin, Italy.
Claudia
C
Coppo
Department of Medical Sciences, University of Turin, Turin, Italy.
Daria
D
Bonfanti
Department of Medical Sciences, University of Turin, Turin, Italy.
Simona
S
Bo
Gastroenterology Unit, Department of Oncology, University of Turin, Turin, Italy.
Chiara
C
Giordanino
Gastroenterology Unit, Department of Oncology, University of Turin, Turin, Italy.
Monica
M
Gallo
Gastroenterology Unit, Department of Oncology, University of Turin, Turin, Italy.
Sara
S
Cococcia
Unit of Cancer Epidemiology, University of Turin, Molinette Hospital and CPO Piemonte, Turin, Italy.
Giovannino
G
Ciccone
Gastro-Hepatology Unit, Department of Medical Sciences, University of Turin, Turin, Italy.
Antonina
A
Smedile
Gastro-Hepatology Unit, Department of Medical Sciences, University of Turin, Turin, Italy.
Alessia
A
Ciancio
Gastro-Hepatology Unit, Department of Medical Sciences, University of Turin, Turin, Italy.
Elisabetta
E
Bugianesi
Institute for Biostructures and Bioimages (CNR), Molecular Biotechnology Center, University of Turin, Italy.
Sharmila
S
Fagoonee
Gastro-Hepatology Unit, Department of Medical Sciences, University of Turin, Turin, Italy.
Rinaldo
R
Pellicano
Gastro-Hepatology Unit, Department of Medical Sciences, University of Turin, Turin, Italy.
Mario
M
Rizzetto
Gastroenterology Unit, Department of Oncology, University of Turin, Turin, Italy. Electronic address: g.saracco@tin.it.
Giorgio Maria
GM
Saracco
D000368:Aged; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology; D015331:Cohort Studies; D015897:Comorbidity; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000453:epidemiology*; D003925:Diabetic Angiopathies / Q000453:epidemiology*; D005260:Female; D019698:Hepatitis C, Chronic / Q000150:complications / Q000453:epidemiology*; D006801:Humans; D015994:Incidence; D008099:Liver / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors
Chronic hepatitis C; Cirrhosis; Diabetes mellitus; Macroangiopathy; Microangiopathy