Reappraisal of the Characteristics of Glucose Abnormalities in Patients With Chronic Hepatitis C Infection

OBJECTIVES: There is growing evidence suggesting the mutual link between type 2 diabetes mellitus (T2DM) and hepatitis C virus (HCV) infection. However, the impact of HCV infection on the suite of glucose abnormalities has rarely been investigated. The study aimed to determine the difference regarding the prevalence and the characteristics of glucose abnormalities between chronic hepatitis C (CHC) patients and community-based controls. It also aimed to investigate the related clinical, virological, and histological features of glucose abnormalities in HCV infection.METHODS: Six hundred eighty-three CHC patients and 515 sex-/age-matched controls were included. Oral glucose tolerance test (OGTT) was performed in 522 CHC patients and 447 controls without known T2DM. Clinical data were assessed upon the different stages of glucose abnormalities based on OGTT results.RESULTS: The prevalence of normoglycemia, IGT, and T2DM in 683 CHC patients was 27.7%, 34.6%, and 37.8%, respectively. There was a significant linear trend from normoglycemia to T2DM in terms of age, family history of T2DM, and advanced liver fibrosis in CHC patients. For those CHC patients without fibrosis, the prevalence of glucose abnormalities reached 67.9% high. All CHC patients carried a significantly higher prevalence than controls regarding those aged <65 yr. For those without known DM, there was a 3.5-fold increase in the prevalence of glucose abnormalities in CHC (65.8%) patients in comparison with controls (35.3%) (OR 3.51, 95% CI 2.70–4.56, P < 0.001).CONCLUSIONS: CHC patients carried a high prevalence of glucose abnormalities. Determination of glucose abnormalities by OGTT may be suggested.

[1]  V. Basevi,et al.  Standards of Medical Care in Diabetes—2012 , 2011, Diabetes Care.

[2]  P. O S I T I O N S T A T E M E N T,et al.  Diagnosis and Classification of Diabetes Mellitus , 2011, Diabetes Care.

[3]  J. Liao Effect of rosiglitazone on the frequency of diabetes. , 2007, Current atherosclerosis reports.

[4]  Shang-Jyh Hwang,et al.  Hepatitis C Viremia Increases the Association With Type 2 Diabetes Mellitus in a Hepatitis B and C Endemic Area: An Epidemiological Link With Virological Implication , 2007, The American Journal of Gastroenterology.

[5]  M. Hsieh,et al.  Metabolic risk factors in southern Taiwanese with impaired fasting glucose of 100 to 109 mg/dL. , 2007, Metabolism: clinical and experimental.

[6]  R. Simó Glucose Abnormalities in Patients With Hepatitis C Virus Infection: Epidemiology and Pathogenesis , 2006, Diabetes Care.

[7]  Kingston H. Tseng,et al.  Standards of Medical Care in Diabetes–2006 , 2006, Diabetes Care.

[8]  M. Laakso,et al.  Effect of rosiglitazone on the frequency of diabetes in patients with impaired glucose tolerance or impaired fasting glucose: a randomised controlled trial , 2006, The Lancet.

[9]  C. Dai,et al.  Viral hepatitis and proteinuria in an area endemic for hepatitis B and C infections: another chain of link? , 2006, Journal of internal medicine.

[10]  M. Hsieh,et al.  The role of thyroid autoantibodies in the development of thyroid dysfunction in Taiwanese chronic hepatitis C patients with interferon‐alpha and ribavirin combination therapy , 2006, Journal of viral hepatitis.

[11]  R. Simó,et al.  Glucose Abnormalities in Patients with Hepatitis C Virus Infection , 2006, Diabetes Care.

[12]  Ming‐Lung Yu,et al.  Treatment of Chronic Hepatitis C in Southern Taiwan , 2005, Intervirology.

[13]  A. Basu,et al.  Chronic Hepatitis C and Type II Diabetes Mellitus: A Prospective Cross-Sectional Study , 2005, The American Journal of Gastroenterology.

[14]  R. Simó,et al.  High prevalence of glucose abnormalities in patients with hepatitis C virus infection: a multivariate analysis considering the liver injury. , 2004, Diabetes care.

[15]  K. Koike,et al.  Hepatitis C virus infection and diabetes: direct involvement of the virus in the development of insulin resistance. , 2004, Gastroenterology.

[16]  J. Shaw,et al.  Follow-up report on the diagnosis of diabetes mellitus. , 2003, Diabetes care.

[17]  M. Laakso,et al.  Acarbose for prevention of type 2 diabetes mellitus: the STOP-NIDDM randomised trial , 2002, The Lancet.

[18]  C. Kahn,et al.  Insulin signalling and the regulation of glucose and lipid metabolism , 2001, Nature.

[19]  M. Szklo,et al.  Prevalence of Type 2 Diabetes Mellitus among Persons with Hepatitis C Virus Infection in the United States , 2000, Annals of Internal Medicine.

[20]  T. Valle,et al.  Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance. , 2001, The New England journal of medicine.

[21]  G. Panarello,et al.  Hepatitis C virus risk: a hepatitis C virus related syndrome , 2000, Journal of internal medicine.

[22]  H. Knobler,et al.  Increased risk of type 2 diabetes in noncirrhotic patients with chronic hepatitis C virus infection. , 2000, Mayo Clinic proceedings.

[23]  N. Turkçapar,et al.  Association of diabetes mellitus and chronic hepatitis C virus infection , 1999, Hepatology.

[24]  P. Raskin,et al.  Report of the expert committee on the diagnosis and classification of diabetes mellitus. , 1999, Diabetes care.

[25]  S. Hadziyannis The spectrum of extrahepatic manifestations in hepatitis C virus infection , 1997, Journal of viral hepatitis.

[26]  M. Sakamoto,et al.  Characterization of the genomic sequence of type V (or 3a) hepatitis C virus isolates and PCR primers for specific detection. , 1993, The Journal of general virology.

[27]  R. Klein,et al.  Onset of NIDDM occurs at Least 4–7 yr Before Clinical Diagnosis , 1992, Diabetes Care.

[28]  D L McGee,et al.  Diabetes and Glucose Tolerance as Risk Factors for Cardiovascular Disease: The Framingham Study , 1979, Diabetes Care.

[29]  S. Fowler,et al.  Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. , 2002, The New England journal of medicine.

[30]  T. T. 1. D. T. S. Group,et al.  Is fasting glucose sufficient to define diabetes? Epidemiological data from 20 European studies , 1999, Diabetologia.

[31]  J. Tuomilehto,et al.  Is fasting glucose sufficient to define diabetes? Epidemiological data from 20 European studies , 1999 .