Journal of the Chinese Medical Association
Volume 69, Issue 4 , Pages 146-152, April 2006

Seroprevalence of Hepatitis B and C in Type 2 Diabetic Patients

  • Hua-Fen Chen

      Affiliations

    • Division of Endocrinology, Department of Internal Medicine, Far-Eastern Memorial Hospital, Panchiao, Taipei, Taiwan, R.O.C.
    • Department of Public Health, College of Medicine, Fu Jen Catholic University, Hsinchuang, Taipei, Taiwan, R.O.C.
    • ,
  • Chung-Yi Li

      Affiliations

    • Department of Public Health, College of Medicine, Fu Jen Catholic University, Hsinchuang, Taipei, Taiwan, R.O.C.
    • ,
  • Peter Chen

      Affiliations

    • Division of Gastroenterology, Department of Internal Medicine, Far-Eastern Memorial Hospital, Panchiao, Taipei, Taiwan, R.O.C.
    • ,
  • Ting-Ting See

      Affiliations

    • Division of Endocrinology, Department of Internal Medicine, Far-Eastern Memorial Hospital, Panchiao, Taipei, Taiwan, R.O.C.
    • ,
  • Hsin-Yu Lee

      Affiliations

    • Division of Endocrinology, Department of Internal Medicine, Far-Eastern Memorial Hospital, Panchiao, Taipei, Taiwan, R.O.C.
    • Corresponding Author InformationCorrespondence to: Dr. Hsin-Yu Lee, Division of Endocrinology, Department of Internal Medicine, Far Eastern Memorial Hospital, 21, Section 2, Nan-Ya South Road, Panchiao 220, Taiwan, R.O.C.

Received 2 August 2005; accepted 2 November 2005.

Article Outline

Background

Many reports in the literature suggest that chronic hepatitis C virus (HCV) infection is associated with diabetes, but the results are conflicting. The aim of our study was to investigate the seroprevalence of hepatitis B virus (HBV) and HCV infections in type 2 diabetes mellitus (DM) patients.

Methods

We collected 820 consecutive type 2 diabetic patients attending 2 of 5 outpatient endocrinology clinics in Far Eastern Memorial Hospital from March to July 2003. The control group consisted of 905 subjects who came for medical check-ups at the Family Medicine Department. We determined hepatitis B surface antigen (HBsAg) and anti-HCV in both groups, using third-generation microparticle enzyme immunoassay.

Results

No significant difference was found between type 2 DM patients and the control group for seropositivity of HBsAg (13.5% versus 12.4%; odds ratio [OR] = 1.09; 95% confidence interval [CI]: 0.77–1.55; p = 0.441), but anti-HCV seropositivity was detected in 6.8% of patients and 2.6% of the control subjects (OR = 2.87; 95% CI: 1.51–5.46; p < 0.001). In anti-HCV-positive DM patients, abnormal alanine aminotransferase was observed in 61.8%, compared with only 34.2% of anti-HCV-negative DM patients (p < 0.001). We did not observe any difference in risk factors for HCV infection between anti-HCV-positive and -negative DM patients.

Conclusion

The rate of seropositive anti-HCV is 2.8 times higher in type 2 DM patients than non-diabetic control subjects.

Key Words:  cross-sectional studies , diabetes mellitus , hepatitis , prevalence , Taiwan

No full text is available. To read the body of this article, please view the PDF online.

 

Back to Article Outline

References 

  1. Mark JB , Skyler JS . The liver and the endocrine system . In:  Schiff EU ,  Sorrell MF ,  Maddrey WC editor. Schiff's Disease of the Liver . Philadelphia: Lippincott-Raven Publishers; 1999;p. 477–488
  2. Salmela PI , Sotaniemi EA , Niemi M , Mäentausta O . Liver function tests in diabetic patients . Diabetes Care . 1984;7:248–254
  3. Stone BG , Van Thiel DH . Diabetes mellitus and liver . Semin Liver Dis . 1985;5:8–28
  4. Foster KJ , Griffith AH , Dewbury K , Price CP , Wright R . Liver disease in patients with diabetes mellitus . Postgrad Med J . 1980;56:767–772
  5. Harrison SA , Kadakia S , Lang KA , Schenker S . Nonalcoholic steatohepatitis: what we know in the new millennium . Am J Gastroenterol . 2002;97:2714–2724
  6. Allison ME , Wreghitt T , Palmer CR , Alexander GJM . Evidence for a link between hepatitis C virus infection and diabetes mellitus in a cirrhotic population . J Hepatol . 1994;21:1135–1139
  7. Özyilkan E , Erbaş T , Şimşek H , Telater F , Kayhan B , Telater H . Increased prevalence of hepatitis C virus antibodies in patients with diabetes mellitus . J Intern Med . 1994;235:283–284
  8. Fraser GM , Harman I , Meller N , Niv Y , Porath A . Diabetes mellitus is associated with chronic hepatitis C but not hepatitis B infection . Isr J Med Sci . 1996;32:526–530
  9. Özyilkan E , Arslan M . Increased prevalence of diabetes mellitus in patients with chronic hepatitis C virus infection . Am J Gastroenterol . 1996;91:1480–1481
  10. Gray H , Wreghitt T , Stratton IM , Alexander GJM , Turner RC , O'Rahilly S . High prevalence of hepatitis C infection in Afro-Caribbean patients with type 2 diabetes and abnormal liver function tests . Diabet Med . 1995;12:244–249
  11. Simó R , Hernández C , Genescá J , JardÌ R , Mesa J . High prevalence of hepatitis C virus infection in diabetic patients . Diabetes Care . 1996;19:998–1000
  12. Caronia S, Taylor K, Pagliaro L, Carr C, Palazzo U, Petrik J, et al  Further evidence for an association between non-insulin-dependent diabetes mellitus and chronic hepatitis C virus infection . Hepatology . 1999;30:1059–1063
  13. Mason AL, Lau JYN, Hoang N, Qian KP, Alexander GJM, Xu L, et al  Association of diabetes mellitus and chronic hepatitis C virus infection . Hepatology . 1999;29:328–333
  14. Bigam DL, Pennington JJ, Carpentier A, Wanless IR, Hemming AW, Croxford R, et al  Hepatitis C-related cirrhosis: a predictor of diabetes after liver transplantation . Hepatology . 2000;32:87–90
  15. Zein NN , Abdulkarim AS , Wiesner RH , Egan KS , Persing DH . Prevalence of diabetes mellitus in patients with end-stage liver cirrhosis due to hepatitis C, alcohol, or cholestatic disease . J Hepatol . 2000;32:209–217
  16. Knobler H , Schihmanter R , Zifroni A , Fenakel G , Schattner A . Increased risk of type 2 diabetes in noncirrhotic patients with chronic hepatitis C virus infection . Mayo Clin Proc . 2000;75:355–359
  17. Sangiorgio L , Attardo T , Gangemi R , Rubino C , Barone M , Lunetta M . Increased frequency of HCV and HBV infection in type 2 diabetic patients . Diabetes Res Clin Pract . 2000;48:147–151
  18. Ryu JK , Lee SB , Hong SJ , Lee S . Association of chronic hepatitis C virus infection and diabetes mellitus in Korean patients . Kor J Intern Med . 2001;16:18–23
  19. Okan V, Araz M, Aktaran S, Karsligil T, Meram I, Bayraktaroglu Z, et al. Increased frequency of HCV but not HBV infection in type 2 diabetic patients in Turkey . Int J Clin Prac . 2002;56:175–177
  20. Thuluvath PJ , John PR . Association between hepatitis C, diabetes mellitus, and race: a case-control study . Am J Gastroenterol . 2003;98:438–441
  21. Arao M, Murase K, Kusakabe A, Yoshioka K, Fukuzawa Y, Ishikawa T, et al  Prevalence of diabetes mellitus in Japanese patients infected chronically with hepatitis C virus . J Gastroenterol . 2003;38:355–360
  22. Wang CS , Wang ST , Yao WJ , Chang TT , Chou P . Community-based study of hepatitis C virus infection and type 2 diabetes: an association affected by age and hepatitis severity status . Am J Epidemiol . 2003;158:1154–1160
  23. Mehta SH , Brancati FL , Sulkowski MS , Strathdee SA , Szklo M , Thomas DL . Prevalence of type 2 diabetes mellitus among persons with hepatitis C virus infection in the United States . Ann Intern Med . 2000;133:592–599
  24. Hui JM, Sud A, Farrell GC, Bandara P, Byth K, Kench JG, et al  Insulin resistance is associated with chronic hepatitis C virus infection and fibrosis progression . Gastroenterology . 2003;125:1695–1704
  25. Shintani Y, Fujie H, Miyoshi H, Tsutsumi T, Tsukamoto K, Kimura S, et al  Hepatitis C virus infection and diabetes: direct involvement of the virus in the development of insulin resistance . Gastroenterology . 2004;126:840–848
  26. Lee PL , Wang JH , Lu SN , Kuo HL . Does hepatits C virus (HCV) infection increase the risk of diabetes mellitus? A cross-sectional community study in a HCV-endemic village . J Intern Med Taiwan . 2003;14:58–61
  27. Sotiropoulos A , Peppas TA , Skliros E , Apostolou O , Kotsini V , Pappas SI . Low prevalence of hepatitis C virus infection in Greek diabetic patients . Diabet Med . 1999;16:250–252
  28. Olmo JA , Serra MA , Rodrigo JM . Liver cirrhosis and diabetes mellitus . J Hepatol . 1996;24:645
  29. Mangia A, Schiavone G, Lezzi G, Marmo R, Bruno F, Villani MR, et al  HCV and diabetes mellitus: evidence for a negative association . Am J Gastroenterol . 1998;93:2363–2367
  30. Alberti A , Bortolotti F . Hepatitis C . In:  Bircher J ,  Benhamou JP ,  McIntyre N ,  Rizzetto M , Rodés  editor. Oxford Textbook of Clinical Hepatology . New York: Oxford University Press; 1999;p. 903–922
  31. Quaranta JF, Tran A, Régnier D, Letestu R, Beusnel C, Fuzibet JG, et al  High prevalence of antibodies to hepatitis C virus (HCV) in patients with anti-thyroid autoantibodies . J Hepatol . 1993;18:136–138
  32. Shiao J , Guo L , McLaws ML . Estimation of the risk of bloodborne pathogens to health care workers after a needlestick injury in Taiwan . Am J Infect Control . 2002;30:15–20
  33. Chang CJ , Ko TC , Liu HW . Seroepidemiology of hepatitis C virus infection among drug abusers in southern Taiwan . J Formos Med Assoc . 1998;97:826–829
  34. Wu JC , Lin HC , Jeng FS , Ma GY , Lee SD , Sheng WY . Prevalence, infectivity, and risk factor analysis of hepatitis C virus infection in prostitutes . J Med Virol . 1993;39:312–317
  35. Sheu JC , Lee SH , Wang JT , Shih LN , Wang TH , Chen DS . Prevalence of anti-HCV and HCV viremia in hemodialysis patients in Taiwan . J Med Virol . 1992;37:108–112
  36. Wang TH , Wang JT , Lin JT , Sheu JC , Sung JL , Chen DS . A prospective study of posttransfusion hepatitis in Taiwan . J Hepatol . 1991;13:38–43
  37. Sun CA, Chen HC, Lu CF, You SL, Mau YC, Ho MS, et al  Transmission of hepatitis C virus in Taiwan: prevalence and risk factors based on a nationwide survey . J Med Virol . 1999;59:290–296
  38. Mason A , Nair S . Is type 2 diabetes another extrahepatic manifestation of HCV infection? . Am J Gastroenterol . 2003;98:243–246
  39. Rubbia-Brandt L, Quadri R, Abid K, Giostra E, Malé P, Mentha G, et al  Hepatocyte steatosis is a cytopathic effect of hepatits C virus genotype 3 . J Hepatol . 2000;33:106–115
  40. Rubbia-Brandt L, Fabris P, Paganin S, Leandro G, Male PJ, Giostra E, et al  Steatosis affects chronic hepatitis C progression in a genotype specific way . Gut . 2004;53:406–412
  41. Poynard T , Ratziu V , Charlotte F , Goodman Z , McHutchison J , Albrecht J . Rates and risk factors of liver fibrosis progression in patients with chronic hepatitis C . J Hepatol . 2001;34:730–739
  42. Mezey E . Clinical features and management of alcoholic liver disease and non-alcoholic steatohepatitis . In:  Zakim D ,  Boyer TD editor. Hepatology: A Textbook of Liver Disease . Philadelphia: Saunders; 2003;p. 923–935
  43. Gretch DR . Diagnostic tests for hepatitis C . Hepatology . 1997;26(suppl):43–47
  44. Lok AS , Gunaratnam NT . Diagnosis of hepatitis C . Hepatology . 1997;26(suppl 1):48–56
  45. Gordis L . More on causal inferences: bias, confounding and interaction . In: Epidemiology . 2nd ed.. Philadelphia: W.B. Saunders; 2000;p. 204–218

PII: S1726-4901(09)70195-9

doi:10.1016/S1726-4901(09)70195-9

Journal of the Chinese Medical Association
Volume 69, Issue 4 , Pages 146-152, April 2006

Article Tools