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Prevalence of Type 2 Diabetes Mellitus among Persons with Hepatitis C Virus Infection in the United States

Shruti H. Mehta, MPH; Frederick L. Brancati, MD, MHS; Mark S. Sulkowski, MD; Steffanie A. Strathdee, PhD; Moyses Szklo, MD, DrPH; and David L. Thomas, MD, MPH
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Copyright ©2004 by the American College of Physicians

Ann Intern Med. 2000;133(8):592-599. doi:10.7326/0003-4819-133-8-200010170-00009
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Background: Hepatitis C virus (HCV) infection may contribute to the development of diabetes mellitus. This relationship has not been investigated at the population level, and its biological mechanism remains unknown.

Objective: To examine the prevalence of type 2 diabetes among persons with HCV infection in a representative sample of the general adult population of the United States.

Design: Cross-sectional national survey.

Setting: The Third National Health and Nutrition Examination Survey, 1988–1994.

Participants: 9841 persons older than 20 years of age for whom data on HCV infection and diabetes were complete.

Measurements: The presence of diabetes was ascertained by using American Diabetes Association guidelines based on fasting plasma glucose measurement and medication history. Presence of HCV infection was assessed by testing for serum HCV-specific antibodies (anti-HCV).

Results: Of the 9841 persons evaluated, 8.4% had type 2 diabetes and 2.1% were anti-HCV positive. Type 2 diabetes occurred more often in persons who were older, were nonwhite, had a high body mass index, and had low socioeconomic status. Type 2 diabetes was less common in persons who acknowledged previous illicit drug use. After adjustment for these factors, persons 40 years of age or older with HCV infection were more than three times more likely than those without HCV infection to have type 2 diabetes (adjusted odds ratio, 3.77 [95% CI, 1.80 to 7.87]). None of the 19 persons with type 1 diabetes were anti-HCV positive.

Conclusion: In the United States, type 2 diabetes occurs more often in persons with HCV infection who are older than 40 years of age.


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Figure 1.
Determination of the study sample.

*Persons were considered eligible if they completed an overnight fast (8 to 24 hours) or reported use of insulin or an oral hypoglycemic agent at the time of the survey. †Persons were excluded if they had a missing or indeterminate plasma glucose level or hepatitis C virus antibody test or if they reported a history of diabetes that was unsubstantiated by medication use or hyperglycemia.

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Figure 2.
Prevalence of type 2 diabetes in persons with and those without hepatitis C virus (HCV) infection.

White bars indicate anti-HCV–negative persons; gray bars indicate anti-HCV–positive persons.

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Summary for Patients

The Association between Infection with Hepatitis C Virus and Diabetes

Copyright ©2004 by the American College of Physicians


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