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Further evidence for an association between non–insulin‐dependent diabetes mellitus and chronic hepatitis C virus infection
Author(s) -
Caronia Simona,
Taylor Kevin,
Pagliaro Luigi,
Carr Colin,
Palazzo Ugo,
Petrik Juraj,
O'Rahilly Stephen,
Shore Sarah,
Tom Brian D.,
Alexander Graeme J. M.
Publication year - 1999
Publication title -
hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 5.488
H-Index - 361
eISSN - 1527-3350
pISSN - 0270-9139
DOI - 10.1002/hep.510300416
Subject(s) - medicine , cirrhosis , diabetes mellitus , gastroenterology , insulin resistance , odds ratio , hepatitis c , hepatitis c virus , insulin , immunology , virus , endocrinology
Non–insulin‐dependent diabetes mellitus (NIDDM) may be associated with chronic hepatitis C virus (HCV) infection. This was studied further in two parts. First, 1,151 patients with HCV‐related cirrhosis and 181 patients with hepatitis B virus (HBV)‐related cirrhosis, well matched for age, sex, and severity of cirrhosis, were reviewed retrospectively. The prevalence of diabetes mellitus was higher in HCV‐related cirrhosis (23.6%) than in HBV‐related cirrhosis (9.4%; odds ratio [OR], 2.78; 95% confidence interval [CI], 1.6‐4.79; P = .0002). The prevalence of diabetes mellitus was associated closely with the Child‐Pugh score (OR, 3.83; 95% CI, 2.38‐6.17; P < .0001) and increasing age (OR, 1.02; 95% CI, 1.00‐1.03; P = .0117). Second, 235 patients with biopsy confirmed chronic HBV or HCV underwent an oral glucose tolerance test. Only 1 of 70 patients with chronic viral hepatitis without cirrhosis was diabetic. However, 31 of 127 patients with HCV‐related cirrhosis (24.4%) were diabetic compared with 3 of 38 patients with HBV‐related cirrhosis (7.9%, P = .0477). The major variables associated with NIDDM were cirrhosis (OR, 14.39; 95% CI, 1.91‐108; P = .0096) and male sex (OR, 4.64; 95% CI, 1.32‐16.18; P = .0161). Fasting insulin levels in 30 patients with HCV‐related cirrhosis and diabetes mellitus were elevated significantly, which was consistent with insulin resistance. However, acute insulin responsiveness was reduced in all patients with HCV infection and diabetes suggesting concomitant B‐cell dysfunction. This study confirms an association between HCV and NIDDM.