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2 型糖尿病伴或不伴慢性丙型肝炎患者微血管病变风险:一项回顾性长期对照队列研究结果。

Risk of microangiopathy in type 2 diabetes mellitus patients with or without chronic hepatitis C: Results of a retrospective long-term controlled cohort study.

机构信息

Gastroenterology Unit, Department of Oncology, University of Turin, Turin, Italy.

Department of Medical Sciences, University of Turin, Turin, Italy.

出版信息

Dig Liver Dis. 2015 May;47(5):405-10. doi: 10.1016/j.dld.2015.01.157. Epub 2015 Feb 7.

Abstract

BACKGROUND

Patients with chronic hepatitis C have an increased risk of diabetes mellitus but the type and risk of developing diabetes-related complications have not yet been evaluated.

METHODS

In order to compare the incidence of diabetic microangiopathy in patients with new onset diabetes without microangiopathy we recruited 54 hepatitis C virus (HCV)-positive and 119 HCV-negative patients from January 2005 to December 2006. All patients were followed-up every 6 months for liver and diabetic complications and incidence of cardiovascular diseases up to December 2012 when data were retrospectively analyzed.

RESULTS

The two cohorts were comparable at enrolment except for mean body mass index, obesity rate and family history of diabetes (p=0.007). After 7.2 years of follow-up, 13 HCV-positive (24.1%) and 37 HCV-negative patients (31%) showed at least one microangiopathic complication (p=0.34); 5 HCV-positive (9.3%) and 13 HCV-negative patients (10.8%) reported cardiovascular diseases (p=0.2); 14 HCV-positive (24.5%) compared to 0 HCV-negative patients developed liver-related complications (p=0.0003). One HCV-positive patient died due to liver cancer, 1 HCV-negative patient died from myocardial infarction (p=0.3). Increasing age (HR=1.04, 95% CI: 1.00-1.07, p=0.04) and smoking (HR=2.94, 95% CI: 1.06-8.17, p=0.04) were positively associated to diabetic complications.

CONCLUSIONS

Incidence of microangiopathy is not significantly different in diabetics with or without chronic hepatitis C.

摘要

背景

慢性丙型肝炎患者发生糖尿病的风险增加,但尚未评估其发生糖尿病相关并发症的类型和风险。

方法

为了比较新诊断的无微血管并发症糖尿病患者中糖尿病性微血管病变的发生率,我们于 2005 年 1 月至 2006 年 12 月招募了 54 名丙型肝炎病毒(HCV)阳性和 119 名 HCV 阴性患者。所有患者在随访期间每 6 个月随访一次,以评估肝和糖尿病并发症及心血管疾病的发生情况,随访截止至 2012 年 12 月,对数据进行回顾性分析。

结果

两组患者在入组时除平均体重指数、肥胖率和糖尿病家族史外(p=0.007),其余特征均相似。经过 7.2 年的随访,13 名 HCV 阳性(24.1%)和 37 名 HCV 阴性(31%)患者出现至少一种微血管并发症(p=0.34);5 名 HCV 阳性(9.3%)和 13 名 HCV 阴性患者(10.8%)报告心血管疾病(p=0.2);14 名 HCV 阳性(24.5%)患者与 0 名 HCV 阴性患者发生与肝脏相关的并发症(p=0.0003)。1 名 HCV 阳性患者死于肝癌,1 名 HCV 阴性患者死于心肌梗死(p=0.3)。年龄增长(HR=1.04,95%CI:1.00-1.07,p=0.04)和吸烟(HR=2.94,95%CI:1.06-8.17,p=0.04)与糖尿病并发症呈正相关。

结论

在患有或不患有慢性丙型肝炎的糖尿病患者中,微血管病变的发生率没有显著差异。

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