Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan.
Genomics Research Center, Academia Sinica, Taipei, Taiwan.
Liver Int. 2017 Feb;37(2):179-186. doi: 10.1111/liv.13194. Epub 2016 Jul 21.
The association between hepatitis C virus (HCV) infection and the occurrence of type II diabetes remains controversial. Prospective studies are needed to assess its causal temporality.
A cohort of 21 559 adults enrolled from seven townships in Taiwan during 1991-1992 and followed till the end of 2010. Incident diabetes over a study time period from 2000 to 2010 was ascertained through computerized linkage with the National Health Insurance database and the National Death Certification profiles. Cox's proportional hazards models were used to estimate hazard ratios (HRs) with 95% confidence intervals (CIs). Antibodies against HCV (anti-HCV) were tested for all participants, and serum HCV RNA levels were measured for anti-HCV seropositives.
During 180 244 person-years of follow-up, there were 1917 incident diabetes cases recorded. The cumulative risk for diabetes was 10.9% for anti-HCV seronegatives and 16.7% for anti-HCV seropositives respectively. The HR for diabetes of anti-HCV seropositivity was 1.53 (95% CI: 1.29-1.81) compared with anti-HCV seronegatives after adjustment for risk predictors. The adjusted HRs were 1.63 (1.31-2.02) for anti-HCV seropositives with positive HCV RNA compared to anti-HCV seronegatives (P<.001).
Chronic HCV infection was associated with an increased risk for diabetes after adjustment for other risk predictors.
丙型肝炎病毒（HCV）感染与 2 型糖尿病发生之间的关联仍存在争议。需要前瞻性研究来评估其因果关系的时间顺序。
1991 年至 1992 年期间，在台湾的七个乡镇招募了 21559 名成年人，并随访至 2010 年底。通过与国家健康保险数据库和国家死亡证明档案的计算机链接，确定了 2000 年至 2010 年研究期间的新发糖尿病病例。使用 Cox 比例风险模型估计风险比（HR）及其 95%置信区间（CI）。对所有参与者进行丙型肝炎病毒抗体（抗-HCV）检测，并对抗-HCV 血清阳性者检测血清 HCV RNA 水平。
在 180244 人年的随访期间，记录了 1917 例新发糖尿病病例。抗-HCV 血清阴性者的糖尿病累积风险为 10.9%，抗-HCV 血清阳性者为 16.7%。抗-HCV 血清阳性者患糖尿病的风险比（HR）为 1.53（95%CI：1.29-1.81），与抗-HCV 血清阴性者相比，调整了风险预测因素后。与抗-HCV 血清阴性者相比，抗-HCV 血清阳性且 HCV RNA 阳性者的调整 HR 为 1.63（1.31-2.02）（P<.001）。
在调整了其他风险预测因素后，慢性 HCV 感染与糖尿病风险增加相关。
