Center for Liver Diseases and Department of Medicine, Inova Fairfax Hospital Betty, Inova Health System, Falls Church, VA, USA.
J Viral Hepat. 2012 May;19(5):341-5. doi: 10.1111/j.1365-2893.2011.01554.x. Epub 2011 Nov 9.
Studies from tertiary care medical centres have linked hepatitis C virus (HCV) to the development of insulin resistance (IR) and type 2 diabetes. The aim of the study is to assess the relationship between HCV positivity and insulin resistance/diabetes in the US population. Three cycles of the National Health and Nutrition Examination Survey (NHANES) conducted between 1988 and 2008 were used. HCV infection was diagnosed using a positive serologic anti-HCV test. Additionally, diabetes was diagnosed as fasting blood glucose ≥126 mg/dL and/or the use of hypoglycaemic medications. Insulin resistance was defined as a homeostasis of model assessment (HOMA) score of >3.0. Logistic regression was used to estimate the odds ratios (ORs) of each of the potential risk factors for diabetes mellitus (DM). The SUDAAN 10.0 was used to run descriptive and regression analyses. A total of 39 506 individuals from three NHANES cycles (1988-1994, 1999-2004 and 2005-2008) with complete demographic and relevant clinical data were included. Over these three NHANES cycles, prevalence of hepatitis C did not significantly change. During the first NHANES cycle (1988-1994), insulin and diabetes were independently associated with hepatitis C. However, during the later study cycles (1998-2008), these associations were no longer significant. In contrast, other important known risk factors for diabetes and IR (male gender, non-Caucasian race, age and obesity) remained significant over all three NHANES cycles. Although HCV infection was independently associated with an increased risk of diabetes and IR in the US population over a decade ago, assessment of the later NHANES cycles shows that this relationship may have become diluted by the rapid rise of other risks for diabetes, specifically, the prevalence of obesity.
来自三级保健医疗中心的研究表明，丙型肝炎病毒（HCV）与胰岛素抵抗（IR）和 2 型糖尿病的发生有关。本研究旨在评估美国人群中 HCV 阳性与胰岛素抵抗/糖尿病之间的关系。该研究使用了 1988 年至 2008 年期间进行的三次全国健康和营养检查调查（NHANES）的三个周期的数据。HCV 感染的诊断采用阳性血清学抗 HCV 检测。此外，糖尿病的诊断标准为空腹血糖≥126mg/dL 和/或使用降血糖药物。胰岛素抵抗定义为稳态模型评估（HOMA）评分>3.0。采用逻辑回归估计每个潜在糖尿病危险因素的比值比（OR）。使用 SUDAAN 10.0 进行描述性和回归分析。共纳入来自三次 NHANES 周期（1988-1994 年、1999-2004 年和 2005-2008 年）的 39506 名个体，这些个体具有完整的人口统计学和相关临床数据。在这三个 NHANES 周期中，丙型肝炎的患病率没有显著变化。在第一个 NHANES 周期（1988-1994 年）中，胰岛素和糖尿病与丙型肝炎独立相关。然而，在随后的研究周期（1998-2008 年）中，这些关联不再显著。相比之下，其他重要的糖尿病和 IR 已知危险因素（男性、非白种人种族、年龄和肥胖）在所有三个 NHANES 周期中均保持显著。尽管 HCV 感染在十多年前与美国人群患糖尿病和 IR 的风险增加独立相关，但对后期 NHANES 周期的评估表明，这种关系可能因肥胖等糖尿病其他风险的迅速增加而变得不明显。
