Further evidence for an association between non-insulin-dependent diabetesmellitus and chronic hepatitis C virus infection

Non-insulin-dependent diabetes mellitus (NIDDM) may be associated with chro nic hepatitis C virus (HCV) infection. This was studied further in two part s. First, 1,151 patients with HCV-related cirrhosis and 181 patients with h epatitis B virus (HBV)-related cirrhosis, well matched for age, sex, and se verity of cirrhosis, were reviewed retrospectively. The prevalence of diabe tes mellitus was higher in HCV-related cirrhosis (23.6%) than in HBV-relate d cirrhosis (9.4%; adds ratio [OR], 2.78; 95% confidence interval [CI], 1.6 -4.79; P = .0002). The prevalence of diabetes mellitus was associated close ly with the Child-Pugh score (OR, 3.83; 95% CI, 2.38-6.17; P < .0001) and i ncreasing age (OR, 1.02; 95% CI, 1.00-1.03; P = .0117). Second, 235 patient s with biopsy confirmed chronic HBV or HCV underwent an oral glucose tolera nce test. Only 1 of 70 patients with chronic viral hepatitis without cirrho sis was diabetic. However, 31 of 127 patients with HCV-related cirrhosis (2 4.4%) were diabetic compared with 3 of 38 patients with HBV-related cirrhos is (7.9%, P = .0477). The major variables associated with NIDDM were cirrho sis (OR, 14.39; 95% CI, 1.91-108; P = .0096) and male sex (OR, 4.64; 95% CI , 1.32-16.18; P = .0161). Fasting insulin levels in 30 patients with HCV-re lated cirrhosis and diabetes mellitus were elevated significantly, which wa s consistent with insulin resistance. However, acute insulin responsiveness was reduced in all patients with HCV infection and diabetes suggesting con comitant B-cell dysfunction. This study confirms an association between HCV and NIDDM.