Increased risk of type 2 diabetes in noncirrhotic patients with chronic hepatitis C virus infection

Objectives: To investigate whether patients with chronic hepatitis C virus (HCV) infection without evidence of cirrhosis have an increased risk of dia betes mellitus (DM) and to evaluate possible risk factors for diabetes in t his group. Patients and Methods: We conducted a case-control study of 45 consecutive e ligible patients with HCV infection and no clinical, scintigraphic? or hist ological evidence of cirrhosis, and a control group of 90 subjects without liver disease matched by age, sex, and body mass index and similar in their origin distribution. Eighty-eight patients with chronic hepatitis B virus (HBV) infection with no evidence of cirrhosis were also evaluated. The diag nosis of diabetes was based on the 1997 American Diabetes Association crite ria. Results: Fifteen patients (33%) with HCV infection were found to have type 2 diabetes compared with 5.6% in the control group without liver disease (P <.001) and 12% in the group with HBV infection (P=.004). Comparison of the patients with and without diabetes revealed that positive family history of diabetes, HCV 1b genotype, and a more severe liver histology were signific antly associated with DM. Conclusions: Patients with chronic HCV infection have an increased prevalen ce of type 2 diabetes, and this prevalence is independent of cirrhosis. The pathogenesis is intriguing, appears to be unique to HCV, and requires furt her study.