Department of Clinical and Experimental Medicine, School of Medicine, University of Pisa, Via Savi 10, I-56126, Pisa, Italy.
Rev Endocr Metab Disord. 2018 Dec;19(4):405-420. doi: 10.1007/s11154-017-9440-1.
Type 2 diabetes mellitus (T2DM) is an endocrine disorder encompassing multifactorial mechanisms, and chronic hepatitis C virus infection (CHC) is a multifaceted disorder, associated with extrahepatic manifestations, including endocrinological disorders. CHC and T2DM are associated, but the subject remains controversial. We performed a systematic review and meta-analysis evaluating such association, searching on PubMed until February 29, 2016. Inclusion criteria were: 1) presence of at least one internal control group age- and gender-matched (non-hepatopathic controls; and/or hepatopathic, not HCV-positive, controls); 2) sufficient data to calculate odds ratio and relative risk. Exclusion criteria were: 1) literature reviews on the topic; 2) publications regarding special populations [human immunodeficiency virus and human T-lymphotropic virus-1 coinfections, hepatocellular carcinoma (HCC), post-transplantation DM, gender selection]; 3) no clear differentiation among HCV patients with CHC, cirrhosis or HCC. Data from each study were independently extracted by two reviewers and cross-checked by AA. Our systematic review returned 544 records, and 33 were included in our meta-analysis. HCV infection is associated with an increased risk of T2DM independently from the severity of the associated liver disease, in CHC and cirrhotic HCV patients. As expected T2DM risk is higher in cirrhotic HCV patients, than CHC, and the prevalence of HCV infection in T2DM patients is higher than in non-diabetic controls. Regarding HBV infection prevalence, no difference exists in diabetic and non-diabetic subjects. An unequivocal CHC and T2DM association was shown. A proactive, integrated approach to HCV and T2DM therapies should maximize benefits of both diseases treatment.
2 型糖尿病（T2DM）是一种包含多因素机制的内分泌疾病，慢性丙型肝炎病毒感染（CHC）是一种多方面的疾病，与肝外表现有关，包括内分泌紊乱。CHC 和 T2DM 相关，但这一主题仍存在争议。我们进行了一项系统评价和荟萃分析，评估这种关联，检索截止日期为 2016 年 2 月 29 日。纳入标准为：1）至少有一组内部对照组年龄和性别匹配（非肝病变对照组；和/或肝病变、非 HCV 阳性对照组）；2）有足够的数据计算比值比和相对风险。排除标准为：1）关于该主题的文献综述；2）涉及特殊人群的出版物[人类免疫缺陷病毒和人类 T 淋巴细胞病毒-1 合并感染、肝细胞癌（HCC）、移植后糖尿病、性别选择]；3）未明确区分 CHC、肝硬化或 HCC 的 HCV 患者。每项研究的数据均由两名评审员独立提取，并由 AA 交叉核对。我们的系统评价共检索到 544 条记录，其中 33 条纳入荟萃分析。HCV 感染与 T2DM 的发生风险增加相关，与相关肝病的严重程度无关，在 CHC 和肝硬化 HCV 患者中均如此。正如预期的那样，肝硬化 HCV 患者的 T2DM 风险高于 CHC，T2DM 患者的 HCV 感染率高于非糖尿病对照组。关于 HBV 感染率，糖尿病和非糖尿病患者之间无差异。明确显示了 CHC 和 T2DM 的关联。积极、综合的 HCV 和 T2DM 治疗方法应最大限度地提高两种疾病治疗的益处。
