Thuluvath Paul J, John Preeti R
Department of Medicine, The Johns Hopkins University School of Medicine, Baltimore, Maryland 21205, USA.
Am J Gastroenterol. 2003 Feb;98(2):438-41. doi: 10.1111/j.1572-0241.2003.07256.x.
A higher prevalence of type II diabetes mellitus (DM) has been reported in patients with hepatitis C virus (HCV) infection. However, in most of these studies, the control population was not matched for body mass index, race, and severity of liver disease, known risk factors for the development of type II DM. The aim of this study was to determine the prevalence of type II DM in patients with HCV cirrhosis compared with a control population matched for age, sex, body mass index, and severity of liver disease.
We conducted a case-control study in a University Hospital setting. We compared 97 cirrhotic patients with HCV (cases) with 194 HCV-negative patients with cirrhosis from other causes (controls). We sought to determine the prevalence of pre- and post-transplant type II DM in cases and controls.
The age, sex, and severity of liver disease were similar in both groups, but there were more blacks in the HCV group (24 of 97, 25%) compared with controls (16 of 194, 8%). The prevalence of pretransplant DM was higher in the HCV group (19.6%) compared with controls (11.5%) (p = 0.06, OR = 1.9, 95% CI = 0.9-3.8). Blacks with HCV had a significantly higher prevalence of pretransplant DM (33.3%) compared with whites with HCV (13.2%) (p = 0.03) and black controls (6.3%) (p = 0.05). Among whites, the prevalence of DM was similar in the HCV group (13.2%) and controls (11.9%). Logistic regression showed that age was the only independent predictor for pretransplant DM (odds ratio = 1.06, 95% CI = 1.01-1.11, p = 0.01). New onset DM was similar in the HCV group (16.7%) and controls (10.1%, p = ns). The new onset of DM was similar in blacks with HCV (31.3%) and black controls (20.0%). However, by logistic regression, black race was an independent predictor for the development of new onset DM (odds ratio = 3.4, 95% CI = 1.2-9.8, p = 0.02).
Our study shows that the prevalence of type II DM is higher in patients with HCV cirrhosis compared with a control group of patients with cirrhosis from other causes, and this was because of a higher prevalence of DM in blacks with HCV infection.
据报道，丙型肝炎病毒（HCV）感染患者中2型糖尿病（DM）的患病率较高。然而，在大多数此类研究中，对照组在体重指数、种族和肝病严重程度（已知的2型糖尿病发病风险因素）方面未进行匹配。本研究的目的是确定与年龄、性别、体重指数和肝病严重程度相匹配的对照组相比，HCV肝硬化患者中2型糖尿病的患病率。
我们在一家大学医院环境中进行了一项病例对照研究。我们将97例HCV肝硬化患者（病例组）与194例其他原因导致的HCV阴性肝硬化患者（对照组）进行了比较。我们试图确定病例组和对照组移植前和移植后2型糖尿病的患病率。
两组患者的年龄、性别和肝病严重程度相似，但HCV组中的黑人（97例中的24例，25%）比对照组（194例中的16例，8%）更多。与对照组（11.5%）相比，HCV组移植前糖尿病的患病率更高（19.6%）（p = 0.06，OR = 1.9，95% CI = 0.9 - 3.8）。HCV感染的黑人移植前糖尿病的患病率（33.3%）显著高于HCV感染的白人（13.2%）（p = 0.03）和黑人对照组（6.3%）（p = 0.05）。在白人中，HCV组（13.2%）和对照组（11.9%）的糖尿病患病率相似。逻辑回归显示，年龄是移植前糖尿病的唯一独立预测因素（比值比 = 1.06，95% CI = 1.01 - 1.11，p = 0.01）。HCV组（16.7%）和对照组（10.1%，p = 无统计学意义）新发糖尿病情况相似。HCV感染的黑人（31.3%）和黑人对照组（20.0%）的新发糖尿病情况相似。然而，通过逻辑回归分析，黑人种族是新发糖尿病发生的独立预测因素（比值比 = 3.4，95% CI = 1.2 - 9.8，p = 0.02）。
我们的研究表明，与其他原因导致的肝硬化对照组相比，HCV肝硬化患者中2型糖尿病的患病率更高，这是因为HCV感染的黑人中糖尿病患病率更高。
