Mason A L, Lau J Y, Hoang N, Qian K, Alexander G J, Xu L, Guo L, Jacob S, Regenstein F G, Zimmerman R, Everhart J E, Wasserfall C, Maclaren N K, Perrillo R P
Section of Gastroenterology and Hepatology, Alton Ochsner Medical Institutions, New Orleans, LA, USA.
Hepatology. 1999 Feb;29(2):328-33. doi: 10.1002/hep.510290235.
While patients with liver disease are known to have a higher prevalence of glucose intolerance, preliminary studies suggest that hepatitis C virus (HCV) infection may be an additional risk factor for the development of diabetes mellitus. To further study the correlation of HCV infection and diabetes, we performed a retrospective analysis of 1,117 patients with chronic viral hepatitis and analyzed whether age, sex, race, hepatitis B virus (HBV) infection, HCV infection, and cirrhosis were independently associated with diabetes. In addition, a case-control study was conducted to determine the seroprevalence of HCV infection in a cohort of 594 diabetics and 377 clinic patients assessed for thyroid disease. In the former study after the exclusion of patients with conditions predisposing to hyperglycemia, diabetes was observed in 21% of HCV-infected patients compared with 12% of HBV-infected subjects (P =.0004). Multivariate analysis revealed that HCV infection (P =.02) and age (P =.01) were independent predictors of diabetes. In the diabetes cohort, 4.2% of patients were found to be infected with HCV compared with 1.6% of control patients (P =.02). HCV genotype 2a was observed in 29% of HCV-RNA-positive diabetic patients versus 3% of local HCV-infected controls (P <.005). In conclusion, the data suggest a relatively strong association between HCV infection and diabetes, because diabetics have an increased frequency of HCV infection, particularly with genotype 2a. Furthermore, it is possible that HCV infection may serve as an additional risk factor for the development of diabetes, beyond that attributable to chronic liver disease alone.
虽然已知肝病患者糖耐量异常的患病率较高，但初步研究表明，丙型肝炎病毒（HCV）感染可能是糖尿病发生的另一个危险因素。为了进一步研究HCV感染与糖尿病的相关性，我们对1117例慢性病毒性肝炎患者进行了回顾性分析，并分析了年龄、性别、种族、乙型肝炎病毒（HBV）感染、HCV感染和肝硬化是否与糖尿病独立相关。此外，还进行了一项病例对照研究，以确定594例糖尿病患者和377例接受甲状腺疾病评估的门诊患者队列中HCV感染的血清流行率。在前一项研究中，排除易患高血糖症的患者后，21%的HCV感染患者患有糖尿病，而HBV感染患者为12%（P = 0.0004）。多变量分析显示，HCV感染（P = 0.02）和年龄（P = 0.01）是糖尿病的独立预测因素。在糖尿病队列中，4.2%的患者被发现感染HCV，而对照患者为1.6%（P = 0.02）。29%的HCV-RNA阳性糖尿病患者检测到HCV基因2a型，而当地HCV感染对照患者为3%（P < 0.005）。总之，数据表明HCV感染与糖尿病之间存在相对较强的关联，因为糖尿病患者HCV感染频率增加，尤其是基因2a型。此外，HCV感染可能是糖尿病发生的另一个危险因素，超出了仅由慢性肝病所致的范围。
