Association between hepatitis C, diabetes mellitus, and race: a case-control study

Abstract

Objective A higher prevalence of type II diabetes mellitus (DM) has been reported in patients with hepatitis C virus (HCV) infection. However, in most of these studies, the control population was not matched for body mass index, race, and severity of liver disease, known risk factors for the development of type II DM. The aim of this study was to determine the prevalence of type II DM in patients with HCV cirrhosis compared with a control population matched for age, sex, body mass index, and severity of liver disease. Methods We conducted a case-control study in a University Hospital setting. We compared 97 cirrhotic patients with HCV (cases) with 194 HCV-negative patients with cirrhosis from other causes (controls). We sought to determine the prevalence of pre- and post-transplant type II DM in cases and controls. Results The age, sex, and severity of liver disease were similar in both groups, but there were more blacks in the HCV group (24 of 97, 25%) compared with controls (16 of 194, 8%). The prevalence of pretransplant DM was higher in the HCV group (19.6%) compared with controls (11.5%) ( p = 0.06, OR = 1.9, 95% CI = 0.9–3.8). Blacks with HCV had a significantly higher prevalence of pretransplant DM (33.3%) compared with whites with HCV (13.2%) ( p = 0.03) and black controls (6.3%) ( p = 0.05). Among whites, the prevalence of DM was similar in the HCV group (13.2%) and controls (11.9%). Logistic regression showed that age was the only independent predictor for pretransplant DM (odds ratio = 1.06, 95% CI = 1.01–1.11, p = 0.01). New onset DM was similar in the HCV group (16.7%) and controls (10.1%, p = ns). The new onset of DM was similar in blacks with HCV (31.3%) and black controls (20.0%). However, by logistic regression, black race was an independent predictor for the development of new onset DM (odds ratio = 3.4, 95% CI = 1.2–9.8, p = 0.02). Conclusions Our study shows that the prevalence of type II DM is higher in patients with HCV cirrhosis compared with a control group of patients with cirrhosis from other causes, and this was because of a higher prevalence of DM in blacks with HCV infection.