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Meta-Analysis
. 2008 Nov;49(5):831-44.
doi: 10.1016/j.jhep.2008.08.006. Epub 2008 Aug 21.

Hepatitis C infection and risk of diabetes: a systematic review and meta-analysis

Donna L White  1 , Vlad Ratziu, Hashem B El-Serag
Affiliations
Meta-Analysis

Hepatitis C infection and risk of diabetes: a systematic review and meta-analysis

Donna L White et al. J Hepatol. 2008 Nov.

Abstract

Background/aims: Several studies found hepatitis C (HCV) increases risk of Type II diabetes mellitus (DM). However, others found no or only sub-group specific excess risk. We performed meta-analyses to examine whether HCV infection does increase DM risk in comparison to the general population and in other sub-groups with increased liver disease rates including with hepatitis B (HBV).

Methods: We followed standard guidelines for performance of meta-analyses. Two independent investigators identified eligible studies through structured keyword searches in relevant databases including PubMed.

Results: We identified 34 eligible studies. Pooled estimators indicated significant DM risk in HCV-infected cases in comparison to non-infected controls in both retrospective (OR(adjusted)=1.68, 95% CI 1.15-2.20) and prospective studies (HR(adjusted)=1.67, 95% CI 1.28-2.06). Excess risk was also observed in comparison to HBV-infected controls (OR(adjusted)=1.80, 95% CI 1.20-1.40) with suggestive excess observed in HCV+/HIV+ cases in comparison to HIV+ controls (OR(unadjusted)=1.82, 95% CI 1.27-2.38).

Conclusions: Our finding of excess DM risk with HCV infection in comparison to non-infected controls is strengthened by consistency of results from both prospective and retrospective studies. The excess risk observed in comparison to HBV-infected controls suggests a potential direct viral role in promoting DM risk, but this needs to be further examined.

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Figures

Figure 1
Figure 1. Forest plots for meta-analyses comparing risk of Type II diabetes in HCV infected cases compared to that in non-infected controls in retrospective studies (n=14)^
^Dimension of shaded odds ratio for individual studies is proportional to their total weight in calculation of the pooled estimator.
Figure 1
Figure 1. Forest plots for meta-analyses comparing risk of Type II diabetes in HCV infected cases compared to that in non-infected controls in retrospective studies (n=14)^
^Dimension of shaded odds ratio for individual studies is proportional to their total weight in calculation of the pooled estimator.
Figure 2
Figure 2. Forest plot of hazard ratios and the overall pooled estimator for longitudinal studies comparing diabetes risk in individuals with HCV infection to that in individuals without HCV infection (n=3)^
^Dimension of shaded hazards ratio for individual studies is proportional to their total weight in calculation of the pooled estimator.
Figure 2
Figure 2. Forest plot of hazard ratios and the overall pooled estimator for longitudinal studies comparing diabetes risk in individuals with HCV infection to that in individuals without HCV infection (n=3)^
^Dimension of shaded hazards ratio for individual studies is proportional to their total weight in calculation of the pooled estimator.
Figure 3
Figure 3. Forest plot for meta-analyses comparing risk of diabetes in HCV-infected cases compared to that in HBV-infected controls (n=8 retrospective studies)^
^Dimension of shaded odds ratio for individual studies is proportional to their total weight in calculation of the pooled estimator.
Figure 3
Figure 3. Forest plot for meta-analyses comparing risk of diabetes in HCV-infected cases compared to that in HBV-infected controls (n=8 retrospective studies)^
^Dimension of shaded odds ratio for individual studies is proportional to their total weight in calculation of the pooled estimator.
See this image and copyright information in PMC

References

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