As
reported in the July 15, 2007 American Journal of Epidemiology, researchers
followed 4958 individuals aged 40 years or older from a community-wide
cohort in southern Taiwan
who did not have diabetes at baseline. Of these, 3486 were seronegative
for both HCV and hepatitis
B virus (HBV), 812 had anti-HCV antibodies but not HBV, 544 had positive hepatitis
B surface antigen (HBsAg) but not HCV, and 116 had HBV-HCV
coinfection.
Participants
were followed for 7 years (1997-2003) to assess the risk of developing diabetes
and its association with HCV infection.
Results
•
A total of 474 participants developed diabetes.
•
The 7-year cumulative incidence of diabetes was:
o7.5% for
HBsAg positive, HCV negative subjects;
o8.6% for
HBV and HCV seronegative subjects;
o14.3% for
HCV positive subjects;
o14.7% for
HBV-HCV coinfected participants.
•
Compared with HCV negative subjects, those with HCV had a 70% higher incidence
of diabetes (P < 0.0001).
•
A multivariate Cox proportional hazards model showed that development of diabetes
was associated with:
oBeing HCV
antibody positive (hazard ratio [HR] 1.7);
oHBV-HCV
coinfection (HR 1.7);
•
Increasing age and being overweight or obese were also significantly
associated with development of diabetes (P < 0.05).
•
Sex, education level, HBsAg status, alcohol consumption,
and tobacco smoking were not significant predictors of diabetes.
•
After stratifying subjects by age and body mass index, the risk ratio for diabetes
in individuals with HCV increased as age decreased and body mass index increased
(P < 0.001).
Conclusion
In
conclusion, the study authors wrote, “Results show that HCV infection is an independent
predictor of diabetes, especially for anti-HCV positive persons who are younger
or have a higher body mass index.”
Since
HCV positive but HBV negative patients had about same incidence of diabetes as
HBV-HCV coinfected individuals, the researchers concluded that while
HCV infection increased the risk of diabetes, HBV alone did not do so.
Based
on these findings, they suggested that diabetes screening and prevention efforts
for individuals with HCV (especially those who are overweight) should be started
earlier than age 45, which is the usual recommendation for the general population.
08/17/07
Reference
CS Wang, ST Wang,
WJ Yao, and others.Hepatitis C virus
infection and the development of type 2 diabetes in a community-based
longitudinal study.American Journal of Epidemiology 166(2): 196-203.
July 15, 2007.
