EXAMINING THE PREVALENCE OF MAJOR RISK FACTORS FOR TYPE-II DIABETES MELLITUS IN PATIENTS WITH LONGSTANDING HEPATITIS-C INFECTION
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Keywords
Diabetes, Hepatitis, Chronic Hep C, Risk factors, Liver function tests, HbA1c.
Abstract
Objective: To examine the major risk factors among individuals with longstanding Hepatitis-C infection that are associated with Type-II Diabetes emergence.
Methodology: In this cross-sectional descriptive study, 130 patients with longstanding hepatitis-C virus (Hep-C) infection were assessed for Type II Diabetes Mellitus (T2DM) prevalence and risk factors at the Department of Medicine, Saidu Medical College Saidu Sharif Swat, Pakistan. Inclusion criteria included patients aged 18 years and above with chronic HCV confirmed by ELISA and PCR, while exclusion criteria ruled out those with other types of hepatitis, non-HCV-related liver diseases, or pre-existing diabetes. Data were collected over one year using a structured questionnaire for demographic and clinical information, along with clinical assessments and blood tests for ALT, AST, HbA1c, and blood sugar levels. Diabetes was diagnosed based on ADA criteria. SPSS version 20.0 was utilized for data analysis. The study, accepted by the hospital's ethics committee, ensured confidentiality and obtained informed consent from participants.
Results: An overall 130 participants were enrolled in this research. The mean age was 45.6 years, with diabetic patients being older (52.4 years) than non-diabetic patients (42.9 years). Males constituted 53.8% of participants, with a higher percentage in the non-diabetic group. 27.4 kg/m² was the mean BMI, with higher values in diabetics (30.1 kg/m²) compared to non-diabetics (26.3 kg/m²). Smoking history was reported by 35.4% of participants, with no significant difference between groups. A history of diabetes in family was more common in diabetics (50.0%) than non-diabetics (18.2%). Older age, high BMI, and family history were significant risk factors for T2DM. Diabetic patients showed higher levels of HbA1c, fasting blood sugar, random blood sugar, ALT, and AST.
Conclusion: We conclude that our research sheds light on the complex link between longstanding hep-C infection and the diabetes mellitus, highlighting the associations with age, BMI, smoking, family history, hypertension, and liver function tests. These perspectives highlight the imperative for holistic treatment approaches that address the multifaceted nature of these conditions, thereby informing personalized therapeutic interventions.
References
2. Khan, M. A. B., Hashim, M. J., King, J. K., Govender, R. D., Mustafa, H., & Al Kaabi, J. (2020). Epidemiology of Type 2 Diabetes - Global Burden of Disease and Forecasted Trends. Journal of epidemiology and global health, 10(1), 107–111. https://doi.org/10.2991/jegh.k.191028.001
3. Animaw, W., & Seyoum, Y. (2017). Increasing prevalence of diabetes mellitus in a developing country and its related factors. PloS one, 12(11), e0187670. https://doi.org/10.1371/journal.pone.0187670
4. Moosavy, S. H., Davoodian, P., Nazarnezhad, M. A., Nejatizaheh, A., Eftekhar, E., & Mahboobi, H. (2017). Epidemiology, transmission, diagnosis, and outcome of Hepatitis C virus infection. Electronic physician, 9(10), 5646–5656. https://doi.org/10.19082/5646
5. Tariq, M., Shoukat, A. B., Akbar, S., Hameed, S., Naqvi, M. Z., Azher, A., Saad, M., Rizwan, M., Nadeem, M., Javed, A., Ali, A., & Aziz, S. (2022). Epidemiology, risk factors, and pathogenesis associated with a superbug: A comprehensive literature review on hepatitis C virus infection. SAGE open medicine, 10, 20503121221105957. https://doi.org/10.1177/20503121221105957
6. Raddatz, D., & Ramadori, G. (2007). Carbohydrate metabolism and the liver: actual aspects from physiology and disease. Zeitschrift fur Gastroenterologie, 45(1), 51–62. https://doi.org/10.1055/s-2006-927394
7. Coman, L. I., Coman, O. A., Bădărău, I. A., Păunescu, H., & Ciocîrlan, M. (2021). Association between Liver Cirrhosis and Diabetes Mellitus: A Review on Hepatic Outcomes. Journal of clinical medicine, 10(2), 262. https://doi.org/10.3390/jcm10020262
8. Hammerstad, S. S., Grock, S. F., Lee, H. J., Hasham, A., Sundaram, N., & Tomer, Y. (2015). Diabetes and Hepatitis C: A Two-Way Association. Frontiers in endocrinology, 6, 134. https://doi.org/10.3389/fendo.2015.00134
9. Negro, F., & Alaei, M. (2009). Hepatitis C virus and type 2 diabetes. World journal of gastroenterology, 15(13), 1537–1547. https://doi.org/10.3748/wjg.15.1537
10. Abdulaziz Alrashed, F., Ahmad, T., Almurdi, M. M., Alqahtani, A. S., Alamam, D. M., & Alsubiheen, A. M. (2023). Investigating the relationship between lifestyle factors, family history, and diabetes mellitus in non-diabetic visitors to primary care centers. Saudi journal of biological sciences, 30(9), 103777. https://doi.org/10.1016/j.sjbs.2023.103777
11. Mishra, P. R., Bharti, A., Arora, R., Mir, I. A., & Punia, V. P. S. (2022). Increased Insulin Resistance in Hepatitis-C Infection-Association with Altered Hepatic Function Testing. Pathophysiology : the official journal of the International Society for Pathophysiology, 29(3), 326–332. https://doi.org/10.3390/pathophysiology29030024
12. Uddin, F., Ali, B., & Junaid, N. (2018). Prevalence Of Diabetic Complications In Newly Diagnosed Type 2 Diabetes Patients In Pakistan: Findings From National Registry. Journal of Ayub Medical College, Abbottabad : JAMC, 30(Suppl 1)(4), S652–S658.
13. Al Humayed, S. M., Mahfouz, A. A., Awadalla, N. J., & Alsabaani, A. A. (2018). Hepatitis C Virus Infection at Primary Healthcare Level in Abha City, Southwestern Saudi Arabia: Is Type 2 Diabetes Mellitus an Associated Factor?. International journal of environmental research and public health, 15(11), 2513. https://doi.org/10.3390/ijerph15112513
14. Negro, F., & Alaei, M. (2009). Hepatitis C virus and type 2 diabetes. World journal of gastroenterology, 15(13), 1537–1547. https://doi.org/10.3748/wjg.15.1537
15. Rehman, G. U., Ali, M., Shah, F., Iqbal, A., Ahmad, A., Hayat, Z., Islam, B., Ali, F., Ikramullah, Jamal, Y., Alam, S., Sajjad, M., & Bhatti, M. Z. (2017). Prevalence of Diabetes Type 2 in Hepatitis C Infected Patients in Kpk, Pakistan. BioMed research international, 2017, 2416281. https://doi.org/10.1155/2017/2416281
16. Cefalu W, American Diabetes A. Classification and diagnosis of diabetes, american diabetes, association. Diabetes Care. 2016;39(1):13–22. doi: 10.2337/dc16-S005. [PubMed: 26696675].
17. Memon, M.S. et al. (2013) ‘Prevalence of type 2 diabetes mellitus in hepatitis C virus infected population: A Southeast Asian study’, Journal of Diabetes Research, 2013, pp. 1–7. doi:10.1155/2013/539361.
18. Nguyen VH, Kam L, Yeo YH, et al. Characteristics and Treatment Rate of Patients With Hepatitis C Virus Infection in the Direct-Acting Antiviral Era and During the COVID-19 Pandemic in the United States. JAMA Netw Open. 2022;5(12):e2245424. doi:10.1001/jamanetworkopen.2022.45424
19. Li, M., Zhou, H., Guan, Y., Peng, H., Wang, S., Zhang, P., & Su, B. (2016). Positive hepatitis B surface antibody is associated with reduced risk of diabetes mellitus in retired female Chinese workers. Journal of diabetes, 8(1), 158–161. https://doi.org/10.1111/1753-0407.12317
20. Xiong, X. F., Wei, L., Xiao, Y., Han, Y. C., Yang, J., Zhao, H., Yang, M., & Sun, L. (2020). Family history of diabetes is associated with diabetic foot complications in type 2 diabetes. Scientific reports, 10(1), 17056. https://doi.org/10.1038/s41598-020-74071-3
21. Villar, L. M., Geloneze, B., Vasques, A. C. J., Pires, M. L. E., Miguel, J. C., da Silva, E. F., Marques, V. A., Scalioni, L. P., & Lampe, E. (2019). Prevalence of hepatitis B and hepatitis C among diabetes mellitus type 2 individuals. PloS one, 14(2), e0211193. https://doi.org/10.1371/journal.pone.0211193
22. Mason AL, Lau JY, Hoang N, Qian K, Alexander GJ, Xu L, et al. Association of diabetes mellitus and chronic hepatitis C virus infection. Hepatology. 1999;29:328–333. [PubMed] [Google Scholar]
23. Simo R, Hernandez C, Genesca J, Jardi R, Mesa J. High prevalence of hepatitis C virus infection in diabetic patients. Diabetes Care. 1996;19:998–1000. [PubMed] [Google Scholar]
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Dr Rashid Ali Khan
Senior Registrar, Department of Medicine, Saidu Medical College Saidu Sharif Swat, Pakistan
Dr Wasim Ajaz
Junior Registrar, Department of Medicine Saidu Group of Teaching Hospital Saidu Sharif Swat, Pakistan
Dr Khushal Nadir Hadi
Resident Medical Officer, Department of Medicine HMC Peshawar, Pakistan
Dr Waqar Khan
Medical Doctor, Department of Medicine HMC Peshawar, Pakistan
Dr Hoor Umar Afridi
Final Year MBBS, KGMC Peshawar, Pakistan
Dr Faraz Waheed
Medical Doctor, Department of Medicine HMC Peshawar, Pakistan
Dr Rabail Irfan
Medical Doctor, Department of Medicine HMC Peshawar, Pakistan
Dr Muhammad Haider Ali
Resident Doctor, HMC Peshawar, Pakistan