Kanwal Fasiha, White Donna L, Jiao Li, Tavakoli-Tabasi Shahriar, Sansgiry Shubhada, Ramsey David J, Kuzniarek Jill, Spiegelman Andrew, El-Serag Hashem B
Clinical Epidemiology and Comparative Effectiveness Program, Section of Health Services Research (IQuESt), Michael E. DeBakey VA Medical Center, Baylor College of Medicine, Houston, TX, USA.
Dig Dis Sci. 2015 Jul;60(7):2030-7. doi: 10.1007/s10620-015-3545-8. Epub 2015 Feb 8.
Few studies have shown that host interleukin-28B (IL28B) genetic polymorphisms are associated with insulin resistance in patients with chronic hepatitis C virus (HCV) infection. However, the clinical relevance of this relationship is unclear.
We examined the association between IL28B genotype for rs12980275 and risk of type 2 diabetes and diabetes-related complications.
We used a cross-sectional study of prospectively recruited male veterans with chronic HCV. We employed logistic regression analysis and adjusted for patients' age, race, body mass index, and hepatic fibrosis.
A total of 528 participants were recruited (mean age 59.1 years; 38.5 % African-American; 40.3 % advanced fibrosis). Of these, 36.1 % were homozygous for favorable AA allele for rs12980275, 49.0 % were heterozygous (AG), and 14.0 % were homozygous for the unfavorable allele (GG). Prevalence of diabetes was significantly lower in patients with both favorable alleles (AA) than that with at least one unfavorable IL28B G allele (21.1 vs. 30.2 %, p = 0.02). Similarly, patients who were homozygous for the favorable alleles had lower prevalence of diabetes-related complications than patients with any unfavorable IL28B allele (5.7 vs. 12.2 %, p = 0.01). This association did not change after adjusting for sociodemographic characteristics, body mass index, and stage of hepatic fibrosis (adjusted ORdiabetes 0.56, 95 % CI 0.35-0.89; ORdiabetes-related complications 0.47, 95 % CI 0.23-0.96).
Patients who have favorable AA IL28B alleles have a lower prevalence of diabetes and related complications compared with patients with unfavorable IL28B rs12980275 genotype. IL28B genotype information may be used to counsel HCV patients regarding their individualized risk of diabetes and diabetes-related complications.
很少有研究表明宿主白细胞介素-28B(IL28B)基因多态性与慢性丙型肝炎病毒(HCV)感染患者的胰岛素抵抗有关。然而,这种关系的临床相关性尚不清楚。
我们研究了rs12980275的IL28B基因型与2型糖尿病风险及糖尿病相关并发症之间的关联。
我们对前瞻性招募的患有慢性HCV的男性退伍军人进行了一项横断面研究。我们采用逻辑回归分析,并对患者的年龄、种族、体重指数和肝纤维化进行了校正。
共招募了528名参与者(平均年龄59.1岁;38.5%为非裔美国人;40.3%为晚期纤维化)。其中,36.1%的人rs12980275的有利AA等位基因是纯合子,49.0%是杂合子(AG),14.0%是不利等位基因(GG)的纯合子。具有两个有利等位基因(AA)的患者中糖尿病的患病率显著低于至少有一个不利的IL28B G等位基因的患者(21.1%对30.2%,p = 0.02)。同样,有利等位基因纯合子的患者与任何不利的IL28B等位基因的患者相比,糖尿病相关并发症的患病率更低(5.7%对12.2%,p = 0.01)。在调整了社会人口统计学特征、体重指数和肝纤维化阶段后,这种关联没有改变(调整后的糖尿病比值比0.56,95%可信区间0.35 - 0.89;糖尿病相关并发症比值比0.47,95%可信区间0.23 - 0.96)。
与具有不利的IL28B rs12980275基因型的患者相比,具有有利的AA IL28B等位基因的患者糖尿病及相关并发症的患病率更低。IL28B基因型信息可用于为HCV患者提供关于其个体糖尿病风险和糖尿病相关并发症的咨询。