Mavrogiannaki A, Karamanos B, Manesis E K, Papatheodoridis G V, Koskinas J, Archimandritis A J
2nd Department of Internal Medicine, Athens University Medical School, Hippokration General Hospital, Athens, Greece.
J Viral Hepat. 2009 Jun;16(6):430-6. doi: 10.1111/j.1365-2893.2009.01077.x. Epub 2009 Feb 6.
Despite several studies, the association of glucose intolerance with chronic hepatitis B (CHB) or C (CHC) virus infection remains controversial. We evaluated the prevalence of glucose intolerance by oral glucose tolerance test (OGTT) in patients with CHB or CHC in comparison with matched controls. In total, 189 consecutive outpatients with CHB or CHC and 189 subjects individually matched for age, sex and body mass index (BMI) were included. OGTT was performed in all cases, except in known diabetics, and glucose intolerance was defined as impaired glucose tolerance (IGT), OGTT-diabetes or known diabetes. Most patients with abnormal OGTT had normal fasting glucose (IGT: 69.8%, OGTT-diabetes: 54.5%). Compared with their own controls, CHB patients had a higher prevalence of IGT (13.6% vs 2.5%, P = 0.018) and family history of diabetes (34.6% vs 16.0%, P = 0.011), while CHC patents had higher prevalence of glucose intolerance (37.0% vs 15.7%, Rho = 0.001), mostly because of more frequent IGT (21.3% vs 6.5%, Rho = 0.003). After age and BMI adjustment, patients with CHC compared with those with CHB had significantly higher prevalence of glucose intolerance (37.0% vs 29.6%, P = 0.037). In conclusion, increased prevalence of glucose intolerance is documented by OGTT both in CHC and CHB patients compared with age, sex and BMI matched controls. Glucose intolerance is more frequent in CHC than CHB patients, regardless of known risk factors. An OGTT might be necessary at the baseline work-up of CHB or CHC patients, as a normal fasting glucose value does not exclude IGT or OGTT-diabetes.
尽管已有多项研究，但葡萄糖耐量异常与慢性乙型肝炎（CHB）或慢性丙型肝炎（CHC）病毒感染之间的关联仍存在争议。我们通过口服葡萄糖耐量试验（OGTT）评估了CHB或CHC患者中葡萄糖耐量异常的患病率，并与匹配的对照组进行比较。总共纳入了189例连续的CHB或CHC门诊患者以及189例年龄、性别和体重指数（BMI）相匹配的个体。除已知糖尿病患者外，所有病例均进行了OGTT，葡萄糖耐量异常定义为糖耐量受损（IGT）、OGTT糖尿病或已知糖尿病。大多数OGTT异常的患者空腹血糖正常（IGT：69.8%，OGTT糖尿病：54.5%）。与各自的对照组相比，CHB患者IGT患病率更高（13.6%对2.5%，P = 0.018）且糖尿病家族史更常见（34.6%对16.0%，P = 0.011），而CHC患者葡萄糖耐量异常患病率更高（37.0%对15.7%，Rho = 0.001），主要是因为IGT更常见（21.3%对6.5%，Rho = 0.003）。在对年龄和BMI进行调整后，与CHB患者相比，CHC患者葡萄糖耐量异常患病率显著更高（37.0%对29.6%，P = 0.037）。总之，与年龄、性别和BMI匹配的对照组相比，OGTT证实CHC和CHB患者中葡萄糖耐量异常的患病率均有所增加。无论已知危险因素如何，CHC患者中葡萄糖耐量异常比CHB患者更常见。在CHB或CHC患者的基线检查中可能需要进行OGTT，因为空腹血糖值正常并不能排除IGT或OGTT糖尿病。
