丙型肝炎病毒感染和2型糖尿病的相关性

Correlation Between Hepatitis C Virus Infection and Type 2 Diabetes Mellitus

目的探讨慢性丙型病毒性肝炎患者中2型糖尿病的患病率及危险因素。方法选取2018年1月至2020年5月于云南省第一人民医院确诊的慢性丙型病毒性肝炎患者294例,根据是否合并2型糖尿病分为丙肝合并糖尿病组70例和丙肝不合并糖尿病组224例,删除缺失的数据,选取丙肝合并糖尿病患者56例,丙肝不合并糖尿病患者59例,再随机选取2020年10月就诊于云南省第一人民医院内分泌代谢科单纯不合并丙肝的2型糖尿病患者52例纳入研究。收集受试者一般临床资料(性别、年龄、地区、饮酒史)及实验室检查(HCV RNA、抗HCV抗体、LDH、AST、ALT、ALP、GGT、TBIL、DBIL、TBA、TP、ALB、GLB、BUN、CR、UA、TC、TG、HDL-C、LDL-C、血糖),利用SPSS26.0统计软件建立数据库并进行分析3组患者间的血生化等指标是否有统计学差异,利用无序多元Logistic回归分析危险因素。结果慢性丙型肝炎患者中合并2型糖尿病检出率为23.8%。在3组中性别、年龄、地区、饮酒、UA、GLB、LDL-C、TC、LDH、GLB、AST、ALT、ALP、GGT、TBiL、DBiL、TBA、TG差异有统计学意义(P<0.05),TP、HDL-C、BUN、CR差异无统计学意义(P>0.05)。无序多元Logistic回归分析显示,年龄及总胆汁酸是慢性丙型病毒性肝炎患者合并2型糖尿病的危险因素(P<0.05)。结论丙型肝炎病毒感染会加重肝损伤,高龄及总胆汁酸水平高的丙肝患者更容易发生2型糖尿病。

Objective To investigate the prevalence of and risk factors for type 2 diabetes mellitus in patients with chronic viral hepatitis C.Methods A total of 294 patients with chronic hepatitis C in Yunnan First People's Hospital from January 2018 to May 2020 were divided into two groups:70 patients with diabetes and 224 patients without diabetes.After deletion of incomplete data,56 patients with hepatitis C complicated with diabetes and 59 patients without diabetes were selected,then another 52 patients with type 2 diabetes mellitus who were treated in Endocrinology and Metabolism Department of Yunnan First People's Hospital in October 2020 were randomly selected for the study.General clinical data(gender,age,Place of residence,alcohol consumption)and laboratory tests(HCV RNA,hepatitis C antibody,LDH,AST,ALP,GGT,TBIL,DBIL,TBA,TP,ALB,GLB,BUN,CR,UA,TC,TG,HDL-C,LDL,blood sugar)were collected,and SPSS26.0 statistical software was used to establish a database and analyze whether there are statistical differences in blood biochemical indexes among the three groups of patients,and use disordered multivariate logistic regression to analyze risk factors.Results The detection rate of type 2 diabetes mellitus in patients with Chronic hepatitis C was 23.8%.There were significant differences in sex,age,region,alcohol consumption,UA,GLB,LDL-C,TC,LDH,GLB,AST,ALP,GGT,TBiL,DBiL,TBA and TG among the three groups(P<0.05),but there were no significant differences in TP,HDL-C,BUN and CR(P>0.05).Disordered multivariate Logistic regression analysis showed that age and TBA were the risk factors of type 2 diabetes in patients with chronic hepatitis C(P<0.05).Conclusion Hepatitis C virus infection can aggravate liver injury,and elderly patients with hepatitis C with high TBA level are more likely to develop type 2 diabetes.