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Lontchi-Yimagou E, Feutseu C, Kenmoe S, Djomkam Zune AL, Kinyuy Ekali SF, Nguewa JL, Choukem SP, Mbanya JC, Gautier JF, Sobngwi E. Non-autoimmune diabetes mellitus and the risk of virus infections: a systematic review and meta-analysis of case-control and cohort studies. Sci Rep 2021; 11:8968. [PMID: 33903699 PMCID: PMC8076178 DOI: 10.1038/s41598-021-88598-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Accepted: 04/12/2021] [Indexed: 02/02/2023] Open
Abstract
A significant number of studies invoked diabetes as a risk factor for virus infections, but the issue remains controversial. We aimed to examine whether non-autoimmune diabetes mellitus enhances the risk of virus infections compared with the risk in healthy individuals without non-autoimmune diabetes mellitus. In this systematic review and meta-analysis, we assessed case-control and cohort studies on the association between non-autoimmune diabetes and viruses. We searched PubMed, Embase, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, and Web of Science with no language restriction, to identify articles published until February 15, 2021. The main outcome assessment was the risk of virus infection in individuals with non-autoimmune diabetes. We used a random-effects model to pool individual studies and assessed heterogeneity (I2) using the χ2 test on Cochrane's Q statistic. This study is registered with PROSPERO, number CRD42019134142. Out of 3136 articles identified, we included 68 articles (90 studies, as the number of virus and or diabetes phenotype varied between included articles). The summary OR between non-autoimmune diabetes and virus infections risk were, 10.8(95% CI: 10.3-11.4; 1-study) for SARS-CoV-2; 3.6(95%CI: 2.7-4.9, I2 = 91.7%; 43-studies) for HCV; 2.7(95% CI: 1.3-5.4, I2 = 89.9%, 8-studies;) for HHV8; 2.1(95% CI: 1.7-2.5; 1-study) for H1N1 virus; 1.6(95% CI: 1.2-2.13, I2 = 98.3%, 27-studies) for HBV; 1.5(95% CI: 1.1-2.0; 1-study) for HSV1; 3.5(95% CI: 0.6-18.3 , I2 = 83.9%, 5-studies) for CMV; 2.9(95% CI: 1-8.7, 1-study) for TTV; 2.6(95% CI: 0.7-9.1, 1-study) for Parvovirus B19; 0.7(95% CI: 0.3-1.5 , 1-study) for coxsackie B virus; and 0.2(95% CI: 0-6.2; 1-study) for HGV. Our findings suggest that, non-autoimmune diabetes is associated with increased susceptibility to viruses especially SARS-CoV-2, HCV, HHV8, H1N1 virus, HBV and HSV1. Thus, these viruses deserve more attention from diabetes health-care providers, researchers, policy makers, and stakeholders for improved detection, overall proper management, and efficient control of viruses in people with non-autoimmune diabetes.
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Affiliation(s)
- Eric Lontchi-Yimagou
- grid.412661.60000 0001 2173 8504Laboratory for Molecular Medicine and Metabolism, Biotechnology Center, University of Yaoundé 1, 3851 Yaoundé, Cameroon
| | - Charly Feutseu
- grid.412661.60000 0001 2173 8504Laboratory for Molecular Medicine and Metabolism, Biotechnology Center, University of Yaoundé 1, 3851 Yaoundé, Cameroon
| | - Sebastien Kenmoe
- Department of Virology, Centre Pasteur of Cameroon, Yaoundé, Cameroon
| | - Alexandra Lindsey Djomkam Zune
- grid.29273.3d0000 0001 2288 3199Department of Biochemistry and Molecular Biology, Faculty of Science, University of Buea, Buea, Cameroon
| | - Solange Fai Kinyuy Ekali
- grid.412661.60000 0001 2173 8504Department of Internal Medicine and Specialties, Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, Yaoundé, Cameroon
| | - Jean Louis Nguewa
- grid.508487.60000 0004 7885 7602INSERM, Cordeliers Research Centre, Sorbonne Paris Cité, Université Paris Descartes, Université Paris Diderot, Paris, France ,grid.508487.60000 0004 7885 7602Assistance Publique-Hôpitaux de Paris, Lariboisière Hospital, Department of Diabetes, Clinical Investigation Centre (CIC-9504), University Paris-Diderot, Paris, France ,grid.508487.60000 0004 7885 7602Faculty of Medicine, University Paris-Diderot, Paris, France
| | - Siméon Pierre Choukem
- grid.8201.b0000 0001 0657 2358Department of Internal Medicine and Specialties, Faculty of Medicine and Pharmaceutical Sciences, University of Dschang, Dschang, Cameroon
| | - Jean Claude Mbanya
- grid.412661.60000 0001 2173 8504Laboratory for Molecular Medicine and Metabolism, Biotechnology Center, University of Yaoundé 1, 3851 Yaoundé, Cameroon ,grid.412661.60000 0001 2173 8504Department of Internal Medicine and Specialties, Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, Yaoundé, Cameroon ,grid.460723.40000 0004 0647 4688National Obesity Centre, Yaoundé Central Hospital, Yaoundé, Cameroon
| | - Jean Francois Gautier
- grid.508487.60000 0004 7885 7602INSERM, Cordeliers Research Centre, Sorbonne Paris Cité, Université Paris Descartes, Université Paris Diderot, Paris, France ,grid.508487.60000 0004 7885 7602Assistance Publique-Hôpitaux de Paris, Lariboisière Hospital, Department of Diabetes, Clinical Investigation Centre (CIC-9504), University Paris-Diderot, Paris, France ,grid.508487.60000 0004 7885 7602Faculty of Medicine, University Paris-Diderot, Paris, France
| | - Eugene Sobngwi
- grid.412661.60000 0001 2173 8504Laboratory for Molecular Medicine and Metabolism, Biotechnology Center, University of Yaoundé 1, 3851 Yaoundé, Cameroon ,grid.412661.60000 0001 2173 8504Department of Internal Medicine and Specialties, Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, Yaoundé, Cameroon ,grid.460723.40000 0004 0647 4688National Obesity Centre, Yaoundé Central Hospital, Yaoundé, Cameroon
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Park SH, Kim DJ, Lee HY. Insulin resistance is not associated with histologic severity in nondiabetic, noncirrhotic patients with chronic hepatitis B virus infection. Am J Gastroenterol 2009; 104:1135-9. [PMID: 19319126 DOI: 10.1038/ajg.2009.6] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVES It is still debated whether hepatitis B virus (HBV) infection is associated with the development of diabetes. Our primary objective was to determine whether insulin resistance is associated with HBV-induced histologic severity. METHODS This study included consecutive 80 nondiabetic, noncirrhotic patients with HBV infection who underwent liver biopsy. We evaluated the relationship between histologic findings and clinical parameters and insulin resistance determined by the homeostasis model assessment (HOMA-IR). RESULTS Patients with minimal fibrosis (stage 0 or 1) had significantly higher levels of insulin and HOMA-IR (P = 0.004, P = 0.028, respectively) compared with matched healthy controls. HOMA-IR is independently associated with body mass index (coefficient, 0.16; 95% confidence interval, CI, 0.03-0.28) but not with HBV-induced histologic activity or fibrosis. Insulin resistance was not significantly different among patients with or without significant fibrosis (stage 2 or 3). In multivariate analysis, Hepatitis B e antigen (HBeAg) positivity (odds ratio, OR, 0.04; 95% CI, 0.01-0.31) and portal/periportal inflammation (OR, 18.6; 95% CI, 3.9-88.2) were independent predictors of significant fibrosis. CONCLUSIONS The observed hyperinsulinemia in HBV-infected patients seems to be from altered insulin metabolism rather than HBV-specific effects. Insulin resistance is not associated with significant fibrosis. The data suggest that hepatic fibrosis in HBV-infected patients is attributable to the virus-induced liver injury, but not to insulin resistance.
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Affiliation(s)
- Seung Ha Park
- Department of Internal Medicine, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon, Korea
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Li-Ng M, Tropp S, Danoff A, Bini EJ. Association between chronic hepatitis B virus infection and diabetes among Asian Americans and Pacific Islanders. Dig Liver Dis 2007; 39:549-56. [PMID: 17416560 DOI: 10.1016/j.dld.2007.02.014] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2006] [Revised: 02/20/2007] [Accepted: 02/20/2007] [Indexed: 12/11/2022]
Abstract
BACKGROUND Asians have a higher prevalence of both diabetes (diabetes mellitus) and chronic hepatitis B virus infection compared to Caucasians. The aim of this study was to investigate whether hepatitis B virus infection was associated with diabetes mellitus among Asian Americans and Pacific Islanders. METHODS We reviewed the electronic medical records of 411 Asian and 424 Pacific Islanders seen at our medical centre over a 5-year period. Diabetes mellitus was defined by the presence of two or more random blood glucose levels > or =200mg/dL, an ICD-9 diagnostic code of diabetes mellitus, or use of medications for diabetes mellitus. Hepatitis B virus infection was defined by a positive HBsAg test. RESULTS Diabetes mellitus was diagnosed in 223 of the 835 subjects (26.7%), whereas hepatitis B virus infection was diagnosed in 56 (13.8%) of the 407 subjects tested for HBsAg. Overall, the prevalence of diabetes mellitus was significantly higher in patients with hepatitis B virus than in those without hepatitis B virus (58.9% vs. 33.3%, P<0.001), and this remained significant after adjustment for potential confounding variables (OR=3.17; 95% CI, 1.58-6.35). When Asians and Pacific Islanders were analysed separately, the prevalence of diabetes mellitus in patients with hepatitis B virus was significantly higher than in those without hepatitis B virus among Asians (65.0% vs. 27.5%, P<0.001) but not in Pacific Islanders (43.8% vs. 37.1%, P=0.60). Among the 390 subjects who were tested for both hepatitis B virus and hepatitis C virus, the prevalence of diabetes mellitus was 29.4% in uninfected subjects, 44.4% in patients with hepatitis B virus monoinfection, 47.2% in patients with hepatitis C virus monoinfection and 85.0% in patients with hepatitis B virus and hepatitis C virus coinfection (P<0.001). CONCLUSIONS Hepatitis B virus infection is strongly associated with diabetes mellitus among Asian Americans, but not in Pacific Islanders, whereas hepatitis C virus infection was associated with diabetes mellitus in both ethnic groups.
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Affiliation(s)
- M Li-Ng
- Department of Medicine, NYU School of Medicine, New York, NY, USA
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