Prevalence of Type-2 Diabetes in Patients with Hepatitis C and B Virus Infection in Jeddah, Saudi Arabia

Abstract

Objectives: To determine the prevalence of type-2 diabetes mellitus (DM) in patients with hepatitis C virus (HCV) and B virus (HBV) infections. Materials and Methods: A cross-sectional study of HCV- and HBV-positive patients admitted to King Abdul Aziz University Hospital, Jeddah, Saudi Arabia, was conducted from January 1999 to September 2000. The following data were collected and analysed: demographic data, the presence and type of DM, details of the treatment, body mass index (BMI), family history of DM, serum transaminases, thrombocytopenia, and presence of liver cirrhosis on liver biopsy. A total of 399 patients were included in the study. Results: 165 (41%) were anti-HCV positive and 234 (59%) were HBsAg positive. Type-2 diabetes was present in 35 of 165 (21.2%) patients with HCV infection, and 33 of 234 (14.1%) with HBV infection. 94% of anti-HCV-positive type-2 diabetes were older than 40 years and 6% were younger, while for nondiabetics the corresponding percentages were 55 and 45%, respectively. 76% of HBsAg-positive type-2 diabetics were older than 40 and 24% were younger, while the corresponding percentages for nondiabetics were 27 and 73%, respectively. Anti-HCV-positive type-2 diabetics, when compared to nondiabetics, had a higher BMI, a frequent family history of DM, elevated serum transaminases, thrombocytopenia, and liver cirrhosis on biopsy. HBsAg-positive type-2 diabetics had only a more frequent family history of DM than did nondiabetics. Conclusion: Our findings indicate that type-2 diabetes is more common in patients with an HCV than with an HBV infection.

Prevalence and Genotype Distribution of Hepatitis C Virus Infection among Patients with Type 2 Diabetes Mellitus

“…The probable role could be due to induction of insulin resistance through destruction of insulin signaling pathways associated with overproduction of proinflammatory cytokines, such as IL-6 and TNF-α, in response to HCV infection and direct and/or indirect immune-mediated cytopathic effects of HCV on pancreatic islet cells, which may result in the destruction of β-cells and subsequently reduced insulin production [4, 21-23]. Insulin resistance presents at the early stages of chronic HCV infectioin, even prior to progression to fibrosis and cirrhosis [21, 22].…”

“…On the other hand, Laloo et al [28] and Akbar et al [23] demonstrated that HCV seropositivity among diabetic patients is associated with raised ALT and AST levels. This discrepancy between our results and those of previous studies might be due to some differences in the duration of diabetes, type of treatment, severity of liver diseases, and level of liver enzymes among diabetic patients in different studies.…”

Peripheral insulin resistance during treatment of chronic hepatitis C with peguilated interferon plus ribavirin

“…The higher prevalence of DM in HCV patients is not exclusively related to cirrhosis. Non-cirrhotic patients with chronic HCV have increased prevalence of type-2 DM compared to non-cirrhotic patients with chronic hepatitis B virus [Akbar et al, 2002].…”

Prevalence and factors affecting occurrence of type 2 diabetes mellitus in Saudi patients with chronic liver disease

“…This is comparable to 22% prevalence of DM-2 in patients with HCV infection reported earlier from the KSA. [15]…”

“…[12–14] However, data from KSA on the factors influencing the occurrence of DM-2 in patients with liver disease are scanty. [15] We carried out this retrospective study with the aim of (a) determining the prevalence of DM-2 in patients with liver disease in KSA and (b) studying and analyzing various factors that could possibly affect the occurrence of DM-2 in patients with liver disease.…”