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埃及糖尿病患者丙型肝炎病毒基因型分布:一项初步研究。

Hepatitis C virus genotype distribution in Egyptian diabetic patients: a preliminary study.

作者信息

Saleh Omayma, Baiomy Azza A, El-desouky Ayman, Zaghloul Hosam, El-Arman Mohammad, Dahab Gamal M, Abdel-Rahman Mohamed S

机构信息

Internal Medicine Department, Faculty of Medicine, Mansoura University, Mansoura City, Egypt.

出版信息

Arab J Gastroenterol. 2013 Mar;14(1):14-9. doi: 10.1016/j.ajg.2013.01.005. Epub 2013 Mar 7.

Abstract

BACKGROUND AND STUDY AIMS

There is controversy regarding whether a specific hepatitis C virus (HCV) genotype is associated with diabetes mellitus. This study aimed to investigate HCV genotype distribution in diabetics and its relation to some clinical and laboratory variables in HCV-positive diabetic versus non-diabetic Egyptians in East Delta.

PATIENTS AND METHODS

The study included 100 HCV-positive patients of which 66 were diabetic in addition to 35 healthy adults as a control group. Clinical assessment, laboratory measurements of plasma glucose, insulin, C-peptide, C-reactive protein (CRP), tumour necrosis factor-α (TNF-α) and liver functions (alanine aminotransferase (ALT), aspartate aminotransferase (AST) and gamma-glutamyltransferase (GGT)) as well as HCV genotype determination were done, and AST/platelet ratio index (APRI) and Homoeostasis Model of Assessment-Insulin Resistance (HOMA-IR) were calculated.

RESULTS

The main results were the presence of HCV genotype 3, in 31.8% of the diabetic group and in 26.5% of the non-diabetic group, while the remainder of cases had genotype 4, the predominant genotype in Egypt. This is the first report of the presence of HCV genotype 3 in about 30% of an Egyptian cohort. However, there was no significant difference in genotype distribution between both groups. Further, there were significantly higher values of HOMA-IR, insulin and C-peptide in HCV-positive groups in comparison to the control group, while TNF-α was significantly higher in the HCV-positive diabetic group. However, there were no significant differences between both genotypes regarding these parameters.

CONCLUSION

Although this study reveals for the first time the presence of HCV genotype 3 in a significant percentage of a group of Egyptian patients, where the majority were diabetic, the association between diabetes and certain HCV genotypes could not be confirmed on the basis of our findings. Hence, taking into consideration the impact of such a finding on the treatment decisions of those patients, further studies are warranted to explore these findings to a greater extent.

摘要

背景与研究目的

丙型肝炎病毒(HCV)的特定基因型是否与糖尿病相关存在争议。本研究旨在调查糖尿病患者中HCV基因型的分布情况,以及在东三角洲地区HCV阳性的糖尿病患者与非糖尿病埃及人中,其与一些临床和实验室变量的关系。

患者与方法

该研究纳入了100例HCV阳性患者,其中66例为糖尿病患者,另外35名健康成年人作为对照组。进行了临床评估、血浆葡萄糖、胰岛素、C肽、C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)和肝功能(丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)和γ-谷氨酰转移酶(GGT))的实验室检测,以及HCV基因型测定,并计算了AST/血小板比值指数(APRI)和稳态模型评估胰岛素抵抗(HOMA-IR)。

结果

主要结果是,糖尿病组中31.8%的患者和非糖尿病组中26.5%的患者存在HCV基因型3,其余病例为基因型4,这是埃及的主要基因型。这是关于约30%的埃及队列中存在HCV基因型3的首次报告。然而,两组之间的基因型分布没有显著差异。此外,与对照组相比,HCV阳性组的HOMA-IR、胰岛素和C肽值显著更高,而HCV阳性糖尿病组的TNF-α显著更高。然而,就这些参数而言,两种基因型之间没有显著差异。

结论

尽管本研究首次揭示了在一组大多数为糖尿病患者的埃及患者中,有相当比例的患者存在HCV基因型3,但根据我们的研究结果,无法证实糖尿病与某些HCV基因型之间的关联。因此,考虑到这一发现对这些患者治疗决策的影响,有必要进一步开展研究,以更深入地探究这些发现。

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