Ma Jiangchen, Ding Xiaowei
Department of Geriatrics, Affiliated Hangzhou First People's Hospital Chengbei Campus, School of Medicine, Westlake University (Hangzhou Geriatric Hospital), Hangzhou, China.
Department of Rehabilitation Medicine, Affiliated Hangzhou First People's Hospital Chengbei Campus, School of Medicine, Westlake University (Hangzhou Geriatric Hospital), Hangzhou, China.
Rev Med Virol. 2025 Jul;35(4):e70039. doi: 10.1002/rmv.70039.
Arboviruses have become endemic worldwide in the recent years. Growing evidence have shown that diabetes increases the risk of severe complications these virus infections, but previous results is conflicting. This systematic review and meta-analysis reassessed the data associated with this correlation to response to the question of whether patients with diabetes have an elevated susceptibility to virus. Four electronic databases of PubMed, Scopus, Web of Science (WoS) and Embase were searched as systematic to evoke relevant data to the risk of virus infection in individuals with diabetes up to January 31, 2025. A random-effects model was used to estimate the summary odds ratio (OR). Subgroup analyses depending on the geographic area, clinical symptoms of virus, study design and the diagnostic techniques of virus were conducted. Quality appraisal for primary outcome and quality assessment was preformed by the Grading of recommendation, assessment, development and evaluation (GRADE) and Newcastle-Ottawa scale (NOS), respectively. This study was registered with PROSPERO, code (CRD42025638835). In total, 33 studies were identified based on different in virus type and phenotype of diabetes. The summary OR between virus infection and the risk of diabetes was (0.81, [95% CI 0.51-1.12], p < 0.05). The separate analysis for each of virus showed an increased risk of severe clinical symptoms of both DENV (OR = 1.04, [95% CI 0.53-1.55], p = 0.00) and WNV (OR = 1.94, [95% CI 1.02-2.87], p = 0.00) except CHIKV (OR = 0.24, [95% CI -0.28-0.76], p = 0.36). No publication bias was observed using Begg's (p = 0.54) and Egger's (P = 0.38) tests. Subgroups of geographic area and severe clinical symptoms of viruses such as dengue fever and West Nile fever had higher risk in diabetic patients. Our results provide strong evidence suggesting the association between diabetes and higher risk of DENV and WNV. These findings will help to physicians to early detection and appropriate management for reducing the morbidity and mortality rates in diabetes patients with DENV and WNV. As a result, diabetes involvement in Arboviruses is usual, especially in DENV and WNV patients.
近年来，虫媒病毒已在全球范围内流行。越来越多的证据表明，糖尿病会增加这些病毒感染引发严重并发症的风险，但此前的研究结果相互矛盾。本系统评价和荟萃分析重新评估了与这种相关性相关的数据，以回答糖尿病患者是否对病毒易感性更高的问题。系统检索了四个电子数据库，即PubMed、Scopus、科学网（WoS）和Embase，以获取截至2025年1月31日与糖尿病个体病毒感染风险相关的相关数据。采用随机效应模型估计汇总比值比（OR）。根据地理区域、病毒的临床症状、研究设计和病毒诊断技术进行亚组分析。分别采用推荐分级、评估、制定与评价（GRADE）和纽卡斯尔-渥太华量表（NOS）对主要结局进行质量评估和质量评价。本研究已在国际前瞻性系统评价注册库（PROSPERO）注册，注册号为（CRD42025638835）。总共确定了33项基于不同病毒类型和糖尿病表型的研究。病毒感染与糖尿病风险之间的汇总OR为（0.81，[95%置信区间0.51 - 1.12]，p < 0.05）。对每种病毒的单独分析显示，除基孔肯雅病毒（CHIKV，OR = 0.24，[95%置信区间 - 0.28 - 0.76]，p = 0.36）外，登革病毒（DENV，OR = 1.04，[95%置信区间0.53 - 1.55]，p = 0.00）和西尼罗病毒（WNV，OR = 1.94，[95%置信区间1.02 - 2.87]，p = 0.00）引发严重临床症状的风险均增加。使用贝格检验（p = 0.54）和埃格检验（P = 0.38）未观察到发表偏倚。地理区域亚组以及登革热和西尼罗热等病毒的严重临床症状亚组在糖尿病患者中的风险更高。我们的结果提供了有力证据，表明糖尿病与登革病毒和西尼罗病毒的较高风险之间存在关联。这些发现将有助于医生早期发现并进行适当管理，以降低糖尿病合并登革病毒和西尼罗病毒患者的发病率和死亡率。因此，糖尿病与虫媒病毒感染相关，尤其是在登革病毒和西尼罗病毒感染患者中。
