Prevalence of diabetes mellitus and insulin resistance in patients with chronic hepatitis C: comparison with hepatitis B virus‐infected and hepatitis C virus‐cleared patients

Imazeki, Fumio; Yokosuka, Osamu; Fukai, Kenichi; Kanda, Tatsuo; Kojima, Hiroshige; Saisho, Hiromitsu

doi:10.1111/j.1478-3231.2007.01630.x

Cited by 92 publications

(94 citation statements)

References 33 publications

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“…Chronic hepatitis C (CHC) could be considered a special type of metabolic disease involving insulin resistance (IR), hepatic steatosis, and modulation of lipid-cholesterol biosynthesis that may lead to fatty liver, hypo-betalipoproteinemia, hypercholesterolemia, and increased risk for ischemic heart diseases (IHD) [2,3]. The association between chronic HCV infection and increased prevalence of IR and type 2 diabetes mellitus (DM) was extensively reported [4]. IR was reported to accelerate fibrosis in chronic HCV-infected patients [5,6], which may lead to increased risk of cirrhosis and hepatocellular carcinoma [7] and has been associated with reduced rate of sustained virological response (SVR) in response to pegylated interferon (IFN)-α and ribavirin therapy [8].…”

Section: Introductionmentioning

confidence: 99%

Study of changes in lipid profile and insulin resistance in Egyptian patients with chronic hepatitis C genotype 4 in the era of DAAs

Sagheer

Soliman

Ahmad

et al. 2018

Libyan Journal of Medicine

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Chronic hepatitis C virus (HCV) infection is associated with altered metabolism, including dyslipidemia and insulin resistance. These contribute to disease progression and influences the response to therapy. To investigate the relationships of new direct-acting antiviral drugs, simeprevir/sofosbuvir, with lipid profile and insulin resistance (IR). Eighty chronic hepatitis C genotype 4 patients were included; they were divided into four groups according to the severity of fibrosis as detected by fibroscan. Forty healthy persons volunteered as a control group. Lipid profile changes and IR were analyzed at baseline and after the end of treatment, and any effect of these changes on the response to treatment was studied. Before treatment, the levels of serum triglycerides were significantly higher in patients than in the control, and the levels of fasting insulin showed a progressive increase with advancing stage of fibrosis. At the end of treatment, there were a significant reduction in serum triglycerides, FBS, fasting insulin, and homeostasis model for the assessment of IR (P < 0.001), and a significant elevation of serum cholesterol and low-density lipoprotein (LDL)-c, high-density lipoprotein (HDL)-c, and LDL/HDL ratio (P = 0.001). An end-of-treatment response (week 12) was achieved in (99%) of the treated cases with 99% sustained viral response for 12 weeks post-treatment (week 24). Significant lipid profile changes were detected at the end of treatment. Serum lipid levels and IR are no longer predictors of response to DAAs. Follow-up of the lipid profile is warranted to avoid any possible remote effect of atherosclerotic heart disease.

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Section: Introductionmentioning

confidence: 99%

Study of changes in lipid profile and insulin resistance in Egyptian patients with chronic hepatitis C genotype 4 in the era of DAAs

Sagheer

Soliman

Ahmad

et al. 2018

Libyan Journal of Medicine

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“…An estimated 1.4-46.7% of patients infected with HCV also have DM, and a meta-analysis shows HCV infection increases the risk of developing DM by approximately 1.7-fold compared to that in non-infected controls (16). Diabetes mellitus also occasionally occurs in HBV-infected patients; previous studies indicate the prevalence rate of DM is 6.3-12% in HBV infection (13)(14)(15)18). However, a recent population-based cohort study suggested that HBV infection had no effect on DM development (27).…”

Section: Discussionmentioning

confidence: 99%

“…Various chronic liver diseases are associated with DM (8,9). Many studies report that HCV increases the incidence of DM (13)(14)(15)(16)(17). The hepatitis C virus induces DM through insulin resistance via a variety of direct and indirect mechanisms (12).…”

Section: Discussionmentioning

confidence: 99%

“…A population-based study indicates that DM increases the overall mortality rate 2.3-30.8-fold in patients with chronic hepatitis B, alcoholic liver disease and non-alcoholic fatty liver disease (NAFLD) (11). Although there are many reports regarding the prevalence of DM in patients with hepatitis C virus (HCV) infection (13)(14)(15)(16)(17), hepatitis B virus (HBV) infection (18), alcoholic liver disease (11,19) and NAFLD (11,20), the incidence rate of DM in AIH has not been reported. The involvement of DM in HCV-infected patients is correlated with hepatic functional reserve (21,22).…”

Section: Introductionmentioning

confidence: 99%

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Prevalence and Risk Factors of Diabetes Mellitus in Patients with Autoimmune Hepatitis

et al. 2016

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Objective The administration of corticosteroids is a standard treatment for autoimmune hepatitis (AIH), but it can occasionally induce various adverse effects. Diabetes mellitus (DM) is a major complication of chronic liver diseases. We investigated the prevalence and risk factors of DM in patients with AIH. Methods We retrospectively analyzed 118 Japanese patients diagnosed with AIH from 1990 to 2014 at our institution. The prognosis of patients with and without DM was also compared. Results Twenty-nine (24.5%) patients had DM and 21 (72.4%) received corticosteroids. The annual cumulative incidence rate of newly diagnosed DM was 1.2%. Multivariate analysis showed that DM occurred in older patients [OR=6.290; 95% confidence interval (CI)=1.230-32.100; p=0.018] with higher serum immunoglobulin G levels (OR=12.400; 95% CI=2.560-60.400; p=0.002). A Cox hazard regression analysis revealed that predictive factors for DM were absence of other autoimmune diseases (OR=0.171; 95% CI=0.036-0.805; p=0.025), use of corticosteroids (OR=6.693; 95% CI=1.391-32.210; p=0.049) and lower platelet counts (OR= 3.873; 95% CI=1.021-14.690; p=0.046). The 10 year survival rates of the DM and non-DM groups were 94.1% and 94.6%, respectively. There was no significant difference between these groups (p=0.293). Conclusion DM occurred in 24.5% of patients with AIH; older age, absence of other autoimmune diseases and higher serum immunoglobulin G levels are risk factors. Taking corticosteroids and a lower platelet count are risk factors for a new onset of DM. DM did not influence the prognosis of AIH patients.

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“…Since HCV infection was identified, numerous epidemiological studies have reported a higher prevalence of diabetes mellitus type 2 (DM2) among HCV-infected patients, although, the initial association of DM2 and liver disease was established and confirmed in patients with advanced liver diseases long time ago (8) . Several studies from different parts of the world have found that 13% to 33% of patients with chronic HCV have associated diabetes, mostly type 2 DM (9) , Chronic HCV, not chronic HBV, can be considered not only a viral disease, but also a special type of metabolic disease (10) . No one can expect, who come first; chronic HCV or DM2 but, it is so clear that, chronic HCV is usually associated with hepatic steatosis, insulin resistance and decrease of adiponectine synthesis that all predispose persons chronically infected with HCV to gradual development of DM2 (11) .…”

Section: Introductionmentioning

confidence: 99%

Prevalence of Hepatitis C Infection Among Diabetics Type 2 at Sharkia Governorate, Egypt

Amin¹,

Ghorab²,

Mohamed³

et al. 2015

Zagazig University Medical Journal

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Background: HCV virus infection and type 2 diabetes mellitus are two major public health problems in Egypt. Egypt has the highest HCV virus prevalence in the world and is considered the ninth in rank of the highest prevalence of diabetes worldwide. The mutual relationship between diabetes and increased HCV infection may be due to the association of HCV with hepatic steatosis, insulin resistance and decrease of adiponectine synthesis as well as the nature of diabetes and its inherent complications and/or frequent parental exposure. Objective: determination of the prevalence of HCV infection in type-2 diabetics in Sharkia Governorate and to explore the predominant risk factors for HCV infection and its relation to some demographic parameters of this locality. Subjects and methods: A cross sectional randomized study was conducted to 642 patients, regardless of gender, body weight, educational level or socioeconomic levels, at multicentre managing diabetic patients at Sharkia governorate. All patients were subjected to detection of HCV-ab by third generation ELISA and HBA1C level Results:The prevalence of HCV infection among type 2 diabetic patients at Sharkia governorate approximates 38.7 %. Higher prevalence was detected among patients between 45 & 65 years old, low socioeconomic level, low educational level, and those who share personal utensils, have other family members infected with HCV. Patients who previously transfused, previous hospitalized, previously received parenteral anti-bilharzial therapy and those receiving insulin injections are also at high risk. Conclusion: As high as 39% of type-2 diabetics at Sharkia Governorate are HCV-infected. Apart from classic risk factors, The most significant independable factors associated with development of HCV infection in type 2 diabetics are low socioeconomic standard and low educational level. Previous blood transfusion, family members infected with HCV, parenteral antibilharzial treatment, sharing personal utensils and previous hospitalization may play also a role.

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Prevalence of diabetes mellitus and insulin resistance in patients with chronic hepatitis C: comparison with hepatitis B virus‐infected and hepatitis C virus‐cleared patients

Abstract: HCV-infected patients showed a higher prevalence of DM and IR than those with HBV infection. However, in Japan, other confounding factors appeared to be more important risk factors for the development of disturbance in glucose metabolism.

Cited by 92 publications

References 33 publications

Study of changes in lipid profile and insulin resistance in Egyptian patients with chronic hepatitis C genotype 4 in the era of DAAs

Study of changes in lipid profile and insulin resistance in Egyptian patients with chronic hepatitis C genotype 4 in the era of DAAs

Prevalence and Risk Factors of Diabetes Mellitus in Patients with Autoimmune Hepatitis

Prevalence of Hepatitis C Infection Among Diabetics Type 2 at Sharkia Governorate, Egypt

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