Hepatitis C virus lnfection and the development of type 2 diabetes in a community-based longitudinal study
Hepatitis C virus lnfection and the development of type 2 diabetes in a community-based longitudinal study
复制标题
DOI：
10.1093/aje/kwm061
复制
发表时间：
2007-07-15
影响因子：
5
通讯作者：
Chou, Pesus
中科院分区：
文献类型：
--
作者：
Wang, Chong-Shan;Wang, Shan-Tair;Chou, Pesus
丙型肝炎病毒（HCV）感染与2型糖尿病发生的时间关系尚不清楚。作者对台湾南部一个社区队列的4，958名年龄≥ 40岁的无糖尿病患者（3，486名血清阴性，812名抗-HCV阳性，116名B病毒/HCV合并感染，544名B表面抗原（HBsAg）阳性）进行了为期7年（1997-2003）的随访，以研究糖尿病与HCV感染相关的风险。共有474名参与者患上了糖尿病。7年累积发生率为HBsAg+7.5%，血清阴性8.6%，抗-HCV +14.3%，合并感染14.7%。与HCV阴性者相比，HCV阳性者的糖尿病累积发病率更高（对数秩检验，p < 0.0001）。多变量考克斯比例风险模型显示，抗HCV阳性（风险比= 1.7，95%置信区间：1.3，2.11）、合并感染（风险比= 1.7）、超重、肥胖和年龄增长与糖尿病显著相关（p < 0.05）。性别、教育程度、HBsAg+状态、饮酒和吸烟无显著性差异。按年龄和体重指数分层后，抗HCV阳性受试者中糖尿病的风险比随着年龄的降低和体重指数水平的增加而增加（p < 0.001）。结果表明，HCV感染是糖尿病的独立预测因子，特别是对于年轻或体重指数较高的抗HCV阳性者。
The temporal relation of hepatitis C virus (HCV) infection to the development of type 2 diabetes remains unknown. The authors followed 4,958 persons aged >= 40 years without diabetes (3,486 seronegative, 812 anti-HCV+, 116 with hepatitis B virus/HCV coinfection, and 544 hepatitis B surface antigen (HBsAg)+) from a community-wide cohort in southern Taiwan for 7 years (1997-2003) to study the risk of diabetes associated with HCV infection. A total of 474 participants developed diabetes. The 7-year cumulative incidence was 7.5% for HBsAg+, 8.6% for seronegative, 14.3% for anti-HCV+, and 14.7% for coinfected participants. Compared with HCV-persons, HCV+ persons had a higher cumulative incidence of diabetes (log-rank test, p < 0.0001). A multivariate Cox proportional hazards model showed that anti-HCV+ (hazard ratio = 1.7, 95% confidence interval: 1.3, 2.11), coinfection (hazard ratio = 1.7), overweight, obesity, and increasing age were significantly associated with diabetes (p < 0.05). Gender, educational level, HBsAg+ status, alcohol consumption, and smoking were not significant. After stratification by age and body mass index, the risk ratio for diabetes in anti-HCV+ participants increased when age decreased and body mass index levels increased (p < 0.001). Results show that HCV infection is an independent predictor of diabetes, especially for anti-HCV+ persons who are younger or have a higher body mass index.