Further evidence for an association between non–insulin-dependent diabetes mellitus and chronic hepatitis C virus infection

✍ Scribed by Simona Caronia; Kevin Taylor; Luigi Pagliaro; Colin Carr; Ugo Palazzo; Juraj Petrik; Stephen O'Rahilly; Sarah Shore; Brian D. Tom; Graeme J. M. Alexander

• Publisher: John Wiley and Sons
• Year: 1999
• Tongue: English
• Weight: 83 KB
• Volume: 30
• Category: Article
• ISSN: 0270-9139
• DOI: 10.1002/hep.510300416

✦ Synopsis

Non-insulin-dependent diabetes mellitus (NIDDM) may be associated with chronic hepatitis C virus (HCV) infection. This was studied further in two parts. First, 1,151 patients with HCV-related cirrhosis and 181 patients with hepatitis B virus (HBV)-related cirrhosis, well matched for age, sex, and severity of cirrhosis, were reviewed retrospectively. The prevalence of diabetes mellitus was higher in HCV-related cirrhosis (23.6%) than in HBV-related cirrhosis (9.4%; odds ratio [OR], 2.78; 95% confidence interval [CI], 1.6-4.79; P ‫؍‬ .0002). The prevalence of diabetes mellitus was associated closely with the Child-Pugh score (OR, 3.83; 95% CI, 2.38-6.17; P F .0001) and increasing age (OR, 1.02; 95% CI, 1.00-1.03; P ‫؍‬ .0117). Second, 235 patients with biopsy confirmed chronic HBV or HCV underwent an oral glucose tolerance test. Only 1 of 70 patients with chronic viral hepatitis without cirrhosis was diabetic. However, 31 of 127 patients with HCV-related cirrhosis (24.4%) were diabetic compared with 3 of 38 patients with HBVrelated cirrhosis (7.9%, P ‫؍‬ .0477). The major variables associated with NIDDM were cirrhosis (OR, 14.39; 95% CI, 1.91-108; P ‫؍‬ .0096) and male sex (OR, 4.64; 95% CI, 1.32-16.18; P ‫؍‬ .0161). Fasting insulin levels in 30 patients with HCV-related cirrhosis and diabetes mellitus were elevated significantly, which was consistent with insulin resistance. However, acute insulin responsiveness was reduced in all patients with HCV infection and diabetes suggesting concomitant B-cell dysfunction. This study confirms an association between HCV and NIDDM. (HEPATOL-OGY 1999;30:1059-1063.)

An association between cirrhosis and abnormalities of glucose metabolism has been recognized for over 20 years. 1 Abbreviations: NIDDM, non-insulin-dependent diabetes mellitus; HCV, hepatitis C virus; HBV, hepatitis B virus; HGV, hepatitis G virus.