Specific phenotype associated with diabetes mellitus secondary to chronic hepatitis C infection

A link between chronic hepatitis C virus (HCV) infection, Type 2 diabetes mellitus and insulin resistance has been suggested by several studies. However, HCV infection appears to be associated with insulin resistance but not with the metabolic syndrome. The aim of this study was to determine whether chronic HCV infection had an impact on the clinical characteristics of Type 2 diabetes.

We studied retrospectively a group of patients with diabetes mellitus associated with HCV infection (HCV-DM) and compared them with patients with conventional Type 2 diabetes (DM).

The HCV-DM patients had a lower body mass index (P = 0.001) and systolic blood pressure (P = 0.04) compared with patients with DM diabetes. Ten patients (27.0%) in the HCV-DM group and 35 (47.3%) in the DM group had microalbuminuria (P = 0.04). DM patients had significantly higher serum creatinine levels than HCV-DM patients [87 (72-108) vs. 77 (64-86) micromol/l, P = 0.02; median (interquartile range)] but creatinine clearance (Cockroft Gault calculation) was similar. One HCV-DM patient (2.7%) and 44 DM patients (59.4%) were treated with hypolipidaemic therapy (P = 0.0001). Even although nearly two-thirds of the overall DM group were prescribed cholesterol-lowering drugs, DM patients had significantly higher total cholesterol, high-density lipoprotein cholesterol and triglyceride levels than HCV-DM patients.

Our study provides further evidence that HCV-DM patients have specific clinical characteristics in comparison with classical DM patients. These data suggest an association between HCV virus infection and the development of insulin resistance or diabetes mellitus without the typical features of the metabolic syndrome.