Matched population-based study examining the risk of type 2 diabetes in people with and without diagnosed hepatitis C virus infection

作者：Schnier C; Wild S; Kurdi Z; Povey C; Goldberg D J; Hutchinson S J^*

来源：Journal of Viral Hepatitis, 2016, 23(8): 596-605.

DOI：10.1111/jvh.12520

• data linkage
• hepatitis C
• matched cohort study
• type 2 diabetes

Meta-analyses have found hepatitis C virus (HCV) infection to be associated with an increased risk of type 2 diabetes mellitus (T2DM). Here, we examine this association within a large population-based study, according to HCV RNA status. A data-linkage approach was used to examine the excess risk of diagnosed T2DM in people diagnosed with antibodies to HCV (anti-HCV) in Scotland (21929 anti-HCV+ves; involving 15827 HCV RNA(+ves), 3927 HCV RNA(-ves) and 2175 with unknown RNA-status) compared to that of a threefold larger general population sample matched for gender, age and postcode (65074 anti-HCV-ves). To investigate effects of ascertainment bias the following periods were studied: up to 1year before (pre-HCV)/within 1year of (peri-HCV)/more than 1year post (post-HCV) the date of HCV-diagnosis. T2DM had been diagnosed in 2.9% of anti-HCV+ves (including 3.2% of HCV RNA(+ves) and 2.3% of HCV RNA(-ves)) and 2.7% of anti-HCV-ves. A higher proportion of T2DM was diagnosed in the peri-HCV period (i.e. around the time of HCV-diagnosis) for the anti-HCV+ves (22%) compared to anti-HCV-ves (10%). In both the pre-HCV and post-HCV periods, only those anti-HCV+ves living in less deprived areas (13% of the cohort) were found to have a significant excess risk of T2DM compared to anti-HCV-ves (adjusted odds ratio in the pre-HCV period: 4.0 for females and 2.3 for males; adjusted hazard ratio in the post-HCV period: 1.5). These findings were similarly observed for both HCV RNA(+ves) (chronic) and HCV RNA(-ves) (resolved). In the largest study of T2DM among chronic HCV-infected individuals to date, there was no evidence to indicate that infection conveyed an appreciable excess risk of T2DM at the population level.

• 出版日期2016-8