Hepatitis C virus infection and type 2 diabetes mellitus in Mexican patients

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Erwin Chiquete
Ana Ochoa-Guzmán
Leopoldo García-Lamas
Francisco Anaya-Gómez
Juan I. Gutiérrez-Manjarrez
Laura V. Sánchez-Orozco
Sergio A. Godínez-Gutiérrez
Montserrat Maldonado
Sonia Román
Arturo Panduro

Keywords

Diabetes mellitus tipo 2, Hepatitis C, Hígado

Resumen

Objetivo: probar que la diabetes mellitus tipo 2 (DM2) es frecuente en mexicanos con infección por virus de la hepatitis C (VHC).

Métodos: 125 adultos positivos a anticuerpos antiVHC (62.4 % mujeres), con pruebas confirmatorias para viremia mediante RT-PCR (63.2 % positivos al ARN del VHC).

Resultados: 22 pacientes presentaron DM2 (17.6 %, IC 95 % = 11.8-25.3); la diabetes fue más frecuente en pacientes con viremia detectable que en negativos (23.3 adversus 9.6 %, p = 0.04), y entre aquellos con enfermedad hepática avanzada que en compensados (28.9 adversus 11.3 %, p = 0.01). Catorce pacientes (17.7 %) recibieron interferón y seis (42.8 %) experimentaron respuesta virológica sostenida; ninguno de los últimos presentaron DM2; dos de los ocho (25 %) no respondedores tuvieron diabetes. Los pacientes con DM2 eran más añosos que aquellos sin diabetes (57.7 adversus 44.5 años, p < 0.001). Después del análisis multivariado ajustado por confusores relevantes, solo la edad se asoció significativamente con DM2.

Conclusiones: la DM2 fue altamente prevalente entre pacientes con infección por el VHC. La edad fue el factor determinante en la ocurrencia de diabetes en este grupo no pareado.

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Referencias

Sistema Nacional de Información en Salud. [Website]. Statistics on general mortality. SINAIS; Mexico: 2008. Accesed on August 24, 2011. Available at http://sinais. salud.gob.mx/

 

Chiquete E, Nuño-González P, Panduro A. Perspectiva histórica de la diabetes mellitus: comprendiendo la enfermedad. Investigación en Salud 2001;III(marzo):5-10.

 

Osler W. The principles and practice of medicine. New York: Appleton; 1942.

 

Tolman KG, Fonseca V, Dalpiaz A, Tan MH. Spectrum of liver disease in type 2 diabetes and management of patients with diabetes and liver disease. Diabetes Care 2007;30(3):734-743.

 

Tellez-Ávila FI, Sánchez-Ávila F, García-Sáenz-de-Sicilia M, Chávez-Tapia NC, Franco-Guzmán AM, López-Arce G, et al. Prevalence of metabolic syndrome, obesity and diabetes type 2 in cryptogenic cirrhosis. World J Gastroenterol 2008;14(30):4771-4775.

 

Kobashi-Margáin RA, Gutiérrez-Grobe Y, Ponciano-Rodríguez G, Uribe M, Méndez-Sánchez N. Prevalence of type 2 diabetes mellitus and chronic liver disease: a retrospective study of the association of two increasingly common diseases in Mexico. Ann Hepatol 2010;9(3):282-288.

 

Pattullo V, Heathcote J. Hepatitis C and diabetes: one treatment for two diseases? Liver Int 2010;30(3):356-364.

 

Allison ME, Wreghitt T, Palmer CR, Alexander GJ. Evidence for a link between hepatitis C virus infection and diabetes mellitus in a cirrhotic population. J Hepatol 1994; 21(6):1135-1139.

 

Fraser GM, Harman I, Meller N, Niv Y, Porath A. Diabetes mellitus is associated with chronic hepatitis C but not chronic hepatitis B infection. Isr J Med Sci 1996;32(7):526-530.

 

Mason AL, Lau JY, Hoang N, Qian K, Alexander GJ, Xu L, et al. Association of diabetes mellitus and chronic hepatitis C virus infection. Hepatology 1999;29(2):328-333.

 

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 chole-static disease. J Hepatol 2000;32(2):209-217.

 

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(8):592-599.

 

Howard AA, Klein RS, Schoenbaum EE. Association of hepatitis C infection and antiretroviral use with diabetes mellitus in drug users. Clin Infect Dis 2003;36(10):1318-1323.

 

Mehta SH, Brancati FL, Strathdee SA, Pankow JS, Netski D, Coresh J. Hepatitis C virus infection and incident type 2 diabetes. Hepatology 2003;38(1):50-56.

 

Lecube A, Hernández C, Genescà J, Esteban JI, Jardí R, Simó R. High prevalence of glucose abnormalities in patients with hepatitis C virus infection: a multivariate analysis considering the liver injury. Diabetes Care 2004;27(5):1171-1175.

 

Wilson C. Hepatitis C infection and type 2 diabetes in American-Indian women. Diabetes Care 2004;27(9):2116-2119.

 

Visnegarwala F, Chen L, Raghavan S, Tedaldi E. Prevalence of diabetes mellitus and dyslipidemia among antiretroviral näive patients co-infected with hepatitis C virus (HCV) and HIV-1 compared to patients without co-infection. J Infect 2005;50(4):331-337.

 

Huang JF, Dai CY, Hwang SJ, Ho CK, Hsiao PJ, Hsieh MY, et al. Hepatitis C viremia increases the association with type 2 diabetes mellitus in a hepatitis B and C endemic area: an epidemiological link with virological implication. Am J Gastroenterol 2007;102(6):1237-1243.

 

Imazeki F, Yokosuka O, Fukai K, Kanda T, Kojima H, Saisho H. Prevalence of diabetes mellitus and insulin resistance in patients with chronic hepatitis C: comparison with hepatitis B virus-infected and hepatitis C virus-cleared patients. Liver Int 2008;28(3):355-362.

 

Milner KL, van der Poorten D, Trenell M, Jenkins AB, Xu A, Smythe G. Chisholm Chronic hepatitis C is associated with peripheral rather than hepatic insulin resistance. Gastro-enterology 2010;138(3):932-41.e1-3.

 

Masini M, Campani D, Boggi U, Menicagli M, Funel N, Pollera M, et al. Hepatitis C virus infection and human pancreatic beta-cell dysfunction. Diabetes Care 2005; 28(4):940-941.

 

Villalpando S, de la Cruz V, Rojas R, Shamah-Levy T, Ávila MA, Gaona B, et al. Prevalence and distribution of type 2 diabetes mellitus in Mexican adult population: a probabilistic survey. Salud Publica Mex 2010;52(Suppl 1):S19-S26.

 

Chiquete E, Sánchez LV, Becerra G, Quintero A, Maldonado M, Panduro A. Performance of the serologic and molecular screening of blood donations for the hepatitis B and C viruses in a Mexican transfusion center. Ann Hepatol 2005;4(4):275-278.

 

Chiquete E, Panduro A. Low prevalence of anti-hepatitis C virus antibodies in Mexico: a systematic review. Inter-virology 2007;50(1):1-8.

 

Chiquete E, Sánchez LV, Maldonado M, Quezada D, Panduro A. Prediction of the hepatitis C viremia using immunoassay data and clinical expertise. Ann Hepatol 2005;4(2):107-114.

 

Rivas-Estilla AM, Sánchez LV, Matsui O, Campollo O, Armendáriz-Borunda J, Segura-Ortega JE, et al. Identification of hepatitis C virus (HCV) genotypes in infected patients from the west of Mexico. Hepatol Res 1998;12 (2):121-130.

 

Chiquete E, Sánchez LV, Panduro A. Routes of infection and clinical outcome of Mexican women reactive to anti-hepatitis C virus antibodies. Hepatol Res 2006;36(2)100-106.

 

Simó R, Lecube A, Genescà J, Esteban JI, Hernández C. Sustained virological response correlates with reduction in the incidence of glucose abnormalities in patients with chronic hepatitis C virus infection. Diabetes Care 2006;29(11):2462-2466.

 

Knobler H, Schattner A. TNF-{alpha}, chronic hepatitis C and diabetes: a novel triad. QJM 2005;98(1):1-6.

 

Negro F, Alaei M. Hepatitis C virus and type 2 diabetes. World J Gastroenterol 2009;15(13):1537-1547.