Brzdęk Michał, Zarębska-Michaluk Dorota, Rzymski Piotr, Lorenc Beata, Janocha-Litwin Justyna, Berak Hanna, Tomasiewicz Krzysztof, Sitko Marek, Mazur Włodzimierz, Janczewska Ewa, Dybowska Dorota, Klapaczyński Jakub, Parfieniuk-Kowerda Anna, Jaroszewicz Jerzy, Piekarska Anna, Flisiak Robert
Collegium Medicum, Jan Kochanowski University, 25-317, Kielce, Poland.
Department of Gastroenterology, Medical University of Lodz, 92-213, Lodz, Poland.
Sci Rep. 2025 Jul 1;15(1):20936. doi: 10.1038/s41598-025-06290-5.
The clinical and metabolic interactions between hepatitis C virus (HCV) infection and diabetes mellitus (DM) are well documented. The study aimed to compare HCV-infected patients with and without DM. The analysis included 18,968 patients treated with direct-acting antivirals (DAAs) between 2015 and 2023, whose data were collected retrospectively. In the study population, 2179 patients (11.5%) were diagnosed with DM. Compared to the non-diabetic population, they were male-dominated (p = 0.003), had a significantly higher proportion of patients aged ≥ 50 years (p < 0.001), and were more burdened with comorbidities (p < 0.001). The most common HCV genotype was 1b with a significantly higher prevalence in the diabetic group (p < 0.001). Liver disease advancement was higher in diabetic patients, with 17.9% advanced fibrosis and 48% cirrhosis compared to 13.2% (p < 0.001) and 21.8% (p < 0.001) in the non-diabetic population. The effectiveness of DAA therapy in patients with DM was significantly lower compared to the population without diabetes, both in intent-to-treat analysis 93.1% vs. 94.6%, p = 0.015, and per-protocol analysis 96.8% vs. 97.7%, p = 0.0128, however, logistic regression analysis did not confirm the role of diabetes as an independent predictor of treatment failure, suggesting that in the absence of other negative prognostic factors, DM alone does not reduce the chances of cure.
丙型肝炎病毒（HCV）感染与糖尿病（DM）之间的临床和代谢相互作用已有充分记录。该研究旨在比较合并和未合并DM的HCV感染患者。分析纳入了2015年至2023年间接受直接抗病毒药物（DAA）治疗的18968例患者，其数据为回顾性收集。在研究人群中，2179例患者（11.5%）被诊断为DM。与非糖尿病人群相比，他们以男性为主（p = 0.003），年龄≥50岁的患者比例显著更高（p < 0.001），且合并症负担更重（p < 0.001）。最常见的HCV基因型为1b，在糖尿病组中的患病率显著更高（p < 0.001）。糖尿病患者的肝病进展更高，17.9%为晚期纤维化，48%为肝硬化，而非糖尿病人群中分别为13.2%（p < 0.001）和21.8%（p < 0.001）。在意向性分析中，DM患者的DAA治疗有效性显著低于非糖尿病人群（93.1%对94.6%，p = 0.015），在符合方案分析中也更低（96.8%对97.7%，p = 0.0128），然而，逻辑回归分析未证实糖尿病是治疗失败的独立预测因素，这表明在没有其他不良预后因素的情况下，仅DM本身不会降低治愈的机会。
