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Reuters Health Information (2006-05-12): Hepatitis C virus infection increases risk of type 2 diabetes


Hepatitis C virus infection increases risk of type 2 diabetes

Last Updated: 2006-05-12 17:43:16 -0400 (Reuters Health)

NEW YORK (Reuters Health) - Patients with hepatitis C virus (HCV) infection who are 40 years of age or older have three times the risk of developing type 2 diabetes compared with their uninfected counterparts, according to a report in the May issue of Diabetes Care.

"HCV is a diabetogenic agent that by means of increasing insulin resistance strongly predisposes infected patients to type 2 diabetes," Dr. Rafael Simo from Hospital Vall d'Hebron, Barcelona, Spain told Reuters Health. Dr. Simo and colleagues reviewed the available evidence concerning the epidemiological association between HCV infection and diabetes.

In all studies that contained a control group, there was a higher prevalence of HCV antibodies among patients with type 2 diabetes than among nondiabetic patients, the authors report. This was not the case for patients with type 1 diabetes.

Similarly, data from the Third National Health and Nutrition Examination Survey (NHANES III) confirmed a three-fold increased risk of type 2 diabetes in patients who were at least 40 years old and infected with HCV. Again, the results indicate, there was no association between HCV infection and type 1 diabetes.

In other studies, HCV-positive patients with chronic hepatitis were three times as likely to have glucose abnormalities, compared with HCV-negative subjects with other liver diseases. Diabetes and impaired fasting glucose were also more common among patients with anti-HCV antibodies.

Research examining the mechanisms linking HCV infection and type 2 diabetes effectively ruled out autoimmunity, iron overload, and direct damage to pancreatic beta cells. Instead, insulin resistance mediated by proinflammatory cytokines appears to be the main pathogenic mechanism.

"Taking into account the clear association between HCV infection and the development of diabetes, and given that HCV is a very prevalent disease affecting approximately 3% of the world's population, it is possible that HCV infection is contributing to the increasing prevalence of type 2 diabetes," Dr. Simo said.

Because HCV infection can be considered a risk factor for diabetes, screening to detect diabetes and pre-diabetic conditions (impaired fasting glucose or impaired glucose tolerance) should be done at least every 3 years, Dr. Simo advised.

Dr. Simo also cited results of recent studies by his group indicating that successful treatment of HCV infection can prevent the subsequent development of type 2 diabetes.

Diabetes Care 2006;29:1140-1146.

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