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基于社区的横断面研究:血脂与丙型肝炎血清阳性和糖尿病的关系。

Community-based cross-sectional study: the association of lipids with hepatitis C seropositivity and diabetes mellitus.

机构信息

Department of Nursing, College of Pharmacy and Health Care, Tajen University, Yenpu, Pingtung, Taiwan.

出版信息

J Gastroenterol Hepatol. 2012 Nov;27(11):1688-94. doi: 10.1111/j.1440-1746.2012.07212.x.

Abstract

BACKGROUND AND AIMS

Hepatitis C virus (HCV) infection is reported to be associated with or to cause type 2 diabetes mellitus (T2DM). Our study aimed to elucidate the role of triglyceride (TG) and cholesterol (CHOL) levels in the association between anti-HCV seropositivity and T2DM in an HCV-endemic area.

METHODS

We analyzed a computerized dataset of 56 338 residents from a community-based comprehensive screening program in Tainan County in southern Taiwan. Fasting glucose, anti-HCV status, hepatitis B surface antigen (HBsAg) status, platelet counts, TG levels, CHOL levels, age, gender, and body mass index were included in the analyses. Multivariate logistic analysis was used to identify factors independently associated with T2DM.

RESULTS

Older age, being overweight, thrombocytopenia, hypertriglyceridemia, hypercholesterolemia, anti-HCV seropositivity, and HBsAg seronegativity were common factors independently associated with diabetes. Among all models of multiple logistic regression analysis used for identifying factors independently associated with T2DM, anti-HCV seropositivity was only identified in the models that included either hypertriglyceridemia or hypercholesterolemia. When subjects were divided into hyperlipidemia (CHOL, > 200 or TG, > 150 mg/dL; n = 33 393) or non-hyperlipidemia subgroups (CHOL, < 200 and TG, < 150 mg/dL; n = 22 945), anti-HCV seropositivity was identified as an independent factor only in the non-hyperlipidemia subgroup. The odds ratio was 1.35, with a 95% confidence interval of 1.17-1.55.

CONCLUSIONS

This study demonstrates that the lipid level is associated with the relationship between T2DM and anti-HCV seropositivity in non-hyperlipidemic individuals. However, the relationship between HCV and T2DM did not exist when the lipid level was not included in the analysis.

摘要

背景和目的

丙型肝炎病毒(HCV)感染据报道与 2 型糖尿病(T2DM)有关,或可导致 2 型糖尿病。我们的研究旨在阐明在 HCV 流行地区,甘油三酯(TG)和胆固醇(CHOL)水平在抗 HCV 阳性与 T2DM 之间的关联中的作用。

方法

我们分析了来自台湾南部台南县社区为基础的综合筛选计划的计算机化数据集,该数据集包含 56338 名居民的资料,包括空腹血糖、抗 HCV 状态、乙型肝炎表面抗原(HBsAg)状态、血小板计数、TG 水平、CHOL 水平、年龄、性别和体重指数。采用多变量逻辑分析来确定与 T2DM 独立相关的因素。

结果

年龄较大、超重、血小板减少、高甘油三酯血症、高胆固醇血症、抗 HCV 阳性和 HBsAg 阴性是与糖尿病独立相关的常见因素。在用于确定与 T2DM 独立相关因素的所有多元逻辑回归分析模型中,只有在包含高甘油三酯血症或高胆固醇血症的模型中才能发现抗 HCV 阳性。当将研究对象分为高脂血症(CHOL,>200 或 TG,>150mg/dL;n=33393)或非高脂血症亚组(CHOL,<200 和 TG,<150mg/dL;n=22945)时,只有在非高脂血症亚组中,抗 HCV 阳性才被确定为独立因素。比值比为 1.35,95%置信区间为 1.17-1.55。

结论

本研究表明,在非高脂血症个体中,血脂水平与 T2DM 和抗 HCV 阳性之间的关系有关。然而,当不包括血脂水平进行分析时,HCV 与 T2DM 之间的关系并不存在。

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