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Different Hepatitis C Virus Infection Statuses Show a Significant Risk of Developing Type 2 Diabetes Mellitus: A Network Meta-Analysis

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Abstract

Background

The role of hepatitis C virus (HCV) infection statuses in the development of type 2 diabetes mellitus (T2DM) has not been completely understood.

Aim

To evaluate the prevalence of T2DM in patients with different HCV infection statuses.

Methods

We conducted a systematic study on T2DM risk in five types of individuals with different HCV infection statuses: non-HCV controls, HCV-cleared patients, chronic HCV patients without cirrhosis, patients with HCV cirrhosis and patients with decompensated HCV cirrhosis. Studies published from 2010 to 2019 were selected. Both pairwise and network meta-analyses were employed to compare the T2DM risk among patients with different HCV infection statuses.

Results

The pairwise meta-analysis showed that non-HCV (OR = 0.60, 95% CI [0.47–0.78]) had a lower risk of T2DM compared with CHC, while cirrhosis had a significant higher risk (OR = 1.90, 95% CI [1.60–2.26]). Network meta-analysis further demonstrated patients with HCV infection were at a significantly higher risk of T2DM than those without HCV infection or with HCV clearance, while decompensated cirrhosis had a significant higher T2DM risk than non-HCV (OR = 3.84, 95% CI [2.01–7.34]), patients with HCV clearance (OR = 3.17, 95% CI [1.49–6.73]), and CHC patients (OR = 2.21, 95% CI [1.24–3.94]).

Conclusions

HCV infection is a significant risk factor for developing T2DM. CHC, cirrhosis, and decompensated cirrhosis contribute to an increasingly greater risk of T2DM, but HCV clearance spontaneously or through clinical treatment may immediately reduce the risk of the onset and development of T2DM.

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Abbreviations

HCV:

Hepatitis C virus

T2DM:

Type 2 diabetes mellitus

CHC:

Chronic hepatitis C

OR:

Odds ratio

CIs:

Confidence intervals

IR:

Insulin resistance

PRISMA:

Preferred Reporting Items for Systematic Reviews and Meta-Analyses

NOS:

Newcastle–Ottawa Quality Assessment Scale

AHRQ:

Agency for Healthcare Research and Quality

NMA:

Network meta-analysis

SUCRA:

Surface under the cumulative ranking curve

ROR:

Ratio of two odds ratios

HD:

Hepatogenous diabetes

SVR:

Sustained virological responses

DAAs:

Direct-acting antivirals

OGTT:

Oral glucose tolerance test

VS:

Versus

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Funding

This work was supported by the Postgraduate Research & Practice Innovation Program of Jiangsu Province [Grant Number KYCX19_2084] and the Undergraduate Training Programs for Innovation and Entrepreneurship of Nantong University [Grant Number 2019152].

Author information

Author notes

  1. Ying Chen and Hanzhen Ji have contributed equally to this work.

Authors and Affiliations

  1. Department of Epidemiology and Medical Statistics, School of Public Health, Nantong University, 9 Se-Yuan Road, Nantong, 226019, Jiangsu, China

    Ying Chen, Jianguo Shao, Yulong Jia, Qi Bao, Jianan Zhu & Yi Shen

  2. Centre for Liver Diseases, Nantong Third People’s Hospital, Nantong University, Nantong, China

    Hanzhen Ji & Jianguo Shao

  3. Research Centre for Public Health, School of Medicine, Tsinghua University, Beijing, China

    Lei Zhang

  4. Melbourne Sexual Health Centre, Alfred Health, Melbourne, VIC, Australia

    Lei Zhang

  5. Central Clinical School, Faculty of Medicine, Nursing and Health Science, Monash University, Melbourne, Australia

    Lei Zhang

  6. School of Public Health and Preventive Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia

    Lei Zhang

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  1. Ying Chen
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Chen, Y., Ji, H., Shao, J. et al. Different Hepatitis C Virus Infection Statuses Show a Significant Risk of Developing Type 2 Diabetes Mellitus: A Network Meta-Analysis. Dig Dis Sci 65, 1940–1950 (2020). https://doi.org/10.1007/s10620-019-05918-7

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