Choi H Y, Kim Y, Cho H, Kim B H, Ki M
Department of Cancer Control and Population Health, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Korea.
Center for Liver Cancer, National Cancer Center, Goyang, Korea.
J Viral Hepat. 2018 Mar;25(3):272-280. doi: 10.1111/jvh.12815. Epub 2017 Dec 8.
While the association between hepatitis C virus (HCV) infection and diabetes has been established, the relationship between hepatitis B virus (HBV) infection and diabetes remains unclear. Therefore, we compared the association between diabetes development in HBV, HCV and co-infected (HBV/HCV) patients to that in noninfected participants using population-based cohort data. We used the National Health Insurance Service-National Sample Cohort, which consists of 514 791 randomly selected persons among those who underwent health check-ups from 2002 to 2003 aged 40-79 years. Adults found to have HBV or HCV infection from 2002 to 2003, without a prior history of diabetes, were selected as subjects. Competing risk regression models were used to estimate cumulative incidence and hazards ratios (HRs) of diabetes development. The cumulative incidences, incidence densities and HRs of diabetes were highest in the co-infected group, followed by those in the HCV-, HBV- and noninfected groups. The 12-year cumulative incidences were as follows: 42.0% in HBV/HCV-, 32.9% in HCV-, 23.9% in HBV- and 18.3% in the noninfected groups. The incidence density per 1000 person-years was 55.0, 51.5, 38.2 and 28.2 for the HBV/HCV-, HCV-, HBV- and noninfected groups, respectively. The adjusted HRs for diabetes were 1.90, 1.68 and 1.41 for the HBV/HCV-, HCV- and HBV-infected groups, respectively. Our findings suggest that both HCV and HBV infections are associated with the development of diabetes; therefore, prevention of, screening for, and treatment of both may reduce the risk of diabetes in these patients.
虽然丙型肝炎病毒（HCV）感染与糖尿病之间的关联已经确立，但乙型肝炎病毒（HBV）感染与糖尿病之间的关系仍不明确。因此，我们利用基于人群的队列数据，比较了HBV、HCV及合并感染（HBV/HCV）患者与未感染参与者发生糖尿病的关联。我们使用了国民健康保险服务-全国样本队列，该队列由2002年至2003年接受健康检查的40至79岁人群中随机选取的514791人组成。将2002年至2003年发现感染HBV或HCV且无糖尿病既往史的成年人选为研究对象。采用竞争风险回归模型估计糖尿病发生的累积发病率和风险比（HRs）。合并感染组糖尿病的累积发病率、发病密度和HRs最高，其次是HCV感染组、HBV感染组和未感染组。12年累积发病率如下：HBV/HCV合并感染组为42.0%，HCV感染组为32.9%，HBV感染组为23.9%，未感染组为18.3%。HBV/HCV合并感染组、HCV感染组、HBV感染组和未感染组每1000人年的发病密度分别为55.0、51.5、38.2和28.2。HBV/HCV合并感染组、HCV感染组和HBV感染组糖尿病的校正HRs分别为1.90、1.68和1.41。我们的研究结果表明，HCV和HBV感染均与糖尿病的发生有关；因此，对两者进行预防、筛查和治疗可能会降低这些患者患糖尿病的风险。
