Association of diabetes and hepatitis C infection: Epidemiologic evidence and pathophysiologic insights

Bahtiyar, Gül; Shin, John; Aytaman, Ayse; Sowers, James R.; McFarlane, Samy I.

doi:10.1007/s11892-004-0023-7

Cited by 69 publications

(41 citation statements)

References 39 publications

(37 reference statements)

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“…2 DM2 is approaching epidemic proportions worldwide and by the year 2025, over 300 million people will have been diagnosed with diabetes mellitus. 3 Both HCV and DM2 are chronic conditions with significant morbidity and mortality. Hence, identification of risk of comorbid HCV and DM2 and associated cerebrovascular disease is important in minimizing morbidity and mortality associated with these comorbid conditions.…”

Section: Learning Objectivesmentioning

confidence: 99%

“…DM2 associated with HCV infection has been observed in large, retrospective case-control and population-based epidemiologic studies. 3 The exact mechanism for the concurrence of these comorbid conditions is unclear.…”

Section: Learning Objectivesmentioning

confidence: 99%

“…[3][4][5][6][7][8][9][10][11][12] An association of DM2 and HCV was reported in a relatively large cohort of 100 patients with cirrhosis; 50% of those with HCV-related cirrhosis had DM2 as opposed to only 9% of those with cirrhosis from other etiologies with an odds ratio of 10:5. This suggested that the association was not with cirrhosis, but with HCV infection specifically.…”

Section: Epidemiology Diabetes Mellitus In Hepatitis C Virus Infectionmentioning

confidence: 99%

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Association of Hepatitis C Virus Infection and Diabetes Mellitus

Mugo¹,

Matta²,

Kurukulasuriya³

et al. 2006

The Endocrinologist

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Both hepatitis C virus infection (HCV) and diabetes mellitus type 2 (DM2) are chronic conditions with significant morbidity and mortality. Over 4 million Americans are seropositive for hepatitis C virus (HCV) infection. DM2 is approaching epidemic proportions worldwide, and by the year 2025, over 300 million people will have been diagnosed with diabetes mellitus. Epidemiologically, there is a relationship between DM2 and chronic HCV infection. Several potential mechanisms explaining this relationship have been suggested, the most important of which seems to be insulin resistance. HCV infection may lead to post receptor insulin signaling defects contributing to insulin resistance and leading to the development of DM2. HCV is also associated with hepatic steatosis to a greater extent than other inflammatory liver diseases. A significant association between elevated serum ferritin level and newly diagnosed DM2 also exists. Interferon-␣ (IFN-␣) therapy is also thought to contribute to the development of diabetes. Diabetes type 1 (DM1) has not been shown to be strongly associated with HCV infection. DM2 has been reported to increase the risk of hepatocellular carcinoma and is also thought to contribute to the excess mortality seen in patients with hepatocellular carcinoma. Given the major clinical implications of HCV and DM2 comorbidity, the question arises whether all patients with HCV should be screened for diabetes mellitus. There is no data evaluating outcomes with this kind of screening, and it may be premature to screen all HCV patients for DM2. However, as more data accumulates, it may become apparent that this is a valid intervention. (The Endocrinologist 2006;16: 41-48) Learning Objectives• Point out ways in which demographic factors such as age and race may help to clarify the established association between type 2 diabetes mellitus (DM2) and hepatocellular carcinoma (HCC). • Identify which of the several pathophysiological mechanisms that have been proposed for the development of DM in HCV-infected individuals is most plausible. • Describe possible complications of these comorbid disorders, particularly HCC, and address the question of whether to screen all HCV-infected persons for DM2.O ver 4 million Americans are seropositive for hepatitis C virus (HCV), which translates to approximately 1.8% of the U.S. population. Currently, over 2.7 million Americans are chronically infected with HCV, and it is the leading cause of chronic liver disease. 1 The current treatment for chronic HCV infection achieves sustained viral clearance in only approximately 50% of patients with chronic HCV-related liver disease. Hepatitis C is associated with numerous adverse effects, including type 2 diabetes mellitus (DM2), and may progress to hepatocellular carcinoma. 2 DM2 is approaching epidemic proportions worldwide and by the year 2025, over 300 million people will have been diagnosed with diabetes mellitus. 3 Both HCV and DM2 are chronic conditions with significant morbidity and mortality. Hence, identification of risk of com...

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Section: Learning Objectivesmentioning

confidence: 99%

Section: Learning Objectivesmentioning

confidence: 99%

Section: Epidemiology Diabetes Mellitus In Hepatitis C Virus Infectionmentioning

confidence: 99%

See 1 more Smart Citation

Association of Hepatitis C Virus Infection and Diabetes Mellitus

Mugo¹,

Matta²,

Kurukulasuriya³

et al. 2006

The Endocrinologist

Self Cite

View full text Add to dashboard Cite

show abstract

“…Therefore, liver disease is associated with metabolic factors, including glucose metabolism and lipid metabolism. In particular, non-alcoholic fatty liver disease (NAFLD) and hepatitis C virus (HCV) infection have common features, such as insulin resistance and hepatic steatosis (1)(2)(3)(4)(5). Insulin resistance results from a dysregulation of insulin secretion and clearance.…”

Section: Introductionmentioning

confidence: 99%

Significance of Hepatic Insulin Clearance in Patients with Chronic Hepatitis C and Non-alcoholic Fatty Liver Disease

et al. 2016

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Objective Hyperinsulinemia plays an important role in the pathophysiological processes of chronic hepatitis C (CHC) and non-alcoholic fatty liver disease (NAFLD). However, there are few reports on hepatic insulin clearance in patients with these diseases. Methods A total of 74 CHC patients and 37 NAFLD patients were enrolled in this study. We evaluated their hepatic insulin clearance, insulin sensitivity and β-cell function with an oral glucose tolerance test. Results Hepatic insulin clearance in the patients with CHC was significantly correlated with platelets (r= 0.271, p=0.020) and liver fibrosis (r=-0.234, p=0.045) and was significantly affected by both steatosis (mild: 0.157±0.078, severe: 0.114±0.053, p=0.024) and fibrosis (mild: 0.167±0.0857, severe: 0.125±0.052, p= 0.010). There were no significant differences in (homeostasis model assessment) HOMA-β among steatosis and fibrosis stages. In the NAFLD patients, those with severe fibrosis had significantly reduced hepatic insulin clearance (mild: 0.135±0.045, severe: 0.098±0.031, p=0.013) and significantly increased HOMA-β (mild: 115.6±67.1, severe: 172.8±65.7, p=0.018) compared with the patients with mild fibrosis. Conclusion Liver fibrosis development is associated with hepatic insulin clearance in both the CHC and NAFLD patients.

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“…Chronic HCV infection has been associated with newonset diabetes both in the general population (16) and liver transplant recipients (17). Bloom et al found a strong association between HCV and PTDM in a kidney transplant population on tacrolimus (18) and HCV was suggested to explain most of the diabetogenic effect of tacrolimus (18).…”

mentioning

confidence: 99%