Mehta S H, Brancati F L, Sulkowski M S, Strathdee S A, Szklo M, Thomas D L
Johns Hopkins Medical Institutions, 615 North Wolfe Street, Box 82, Baltimore, MD 21205, USA.
Ann Intern Med. 2000 Oct 17;133(8):592-9. doi: 10.7326/0003-4819-133-8-200010170-00009.
Hepatitis C virus (HCV) infection may contribute to the development of diabetes mellitus. This relationship has not been investigated at the population level, and its biological mechanism remains unknown.
To examine the prevalence of type 2 diabetes among persons with HCV infection in a representative sample of the general adult population of the United States.
Cross-sectional national survey.
The Third National Health and Nutrition Examination Survey, 1988-1994.
9841 persons older than 20 years of age for whom data on HCV infection and diabetes were complete.
The presence of diabetes was ascertained by using American Diabetes Association guidelines based on fasting plasma glucose measurement and medication history. Presence of HCV infection was assessed by testing for serum HCV-specific antibodies (anti-HCV).
Of the 9841 persons evaluated, 8.4% had type 2 diabetes and 2.1% were anti-HCV positive. Type 2 diabetes occurred more often in persons who were older, were nonwhite, had a high body mass index, and had low socioeconomic status. Type 2 diabetes was less common in persons who acknowledged previous illicit drug use. After adjustment for these factors, persons 40 years of age or older with HCV infection were more than three times more likely than those without HCV infection to have type 2 diabetes (adjusted odds ratio, 3.77 [95% CI, 1.80 to 7.87]). None of the 19 persons with type 1 diabetes were anti-HCV positive.
In the United States, type 2 diabetes occurs more often in persons with HCV infection who are older than 40 years of age.
丙型肝炎病毒(HCV)感染可能促使糖尿病的发生。这种关系尚未在人群层面进行研究,其生物学机制仍不清楚。
在美国一般成年人群的代表性样本中,研究HCV感染者中2型糖尿病的患病率。
全国性横断面调查。
1988 - 1994年第三次全国健康和营养检查调查。
9841名年龄超过20岁且HCV感染和糖尿病数据完整的人。
根据美国糖尿病协会基于空腹血糖测量和用药史的指南确定糖尿病的存在。通过检测血清HCV特异性抗体(抗-HCV)评估HCV感染情况。
在评估的9841人中,8.4%患有2型糖尿病,2.1%抗-HCV阳性。2型糖尿病在年龄较大、非白人、体重指数高且社会经济地位低的人群中更常见。在承认有过非法药物使用史的人群中2型糖尿病较少见。在对这些因素进行调整后,40岁及以上的HCV感染者患2型糖尿病的可能性是未感染HCV者的三倍多(调整后的优势比,3.77 [95%可信区间,1.80至7.87])。19名1型糖尿病患者中无一抗-HCV阳性。
在美国,40岁以上的HCV感染者患2型糖尿病的情况更常见。