| Objective To investigate the relationship of type 2 diabetes mellitus and chronic hepatitis C (CHC) between Han and Korean in Yanbian area of Jilin Province, China, and to approach the characteristics of hepatitis C virus (HCV) genotype by investigating the incidence of type 2 diabetes mellitus in chronic hepatitis C patients and the characteristics of HCV genotype.Methods 367 CHC patients (218 Korean and 149 Han),352 chronic hepatitis B (CHB) patients and 681 healthy examination people were compared and studied in order to confirm whether it is type 2 diabetes mellitus and to analyze the characteristics of diabetes mellitus in patients with CHC. Anti-HCV antibody and HBsAg in the sera of 851 patients with type 2 diabetes mellitus and 782 people without type 2 diabetes mellitus were detected by enzyme linked immunosorbent assay (ELISA). HCV-RNA load and HCV genotype was analyzed in 62 patients of Korean and 57 patients of Han CHC using real-time PCR and PCR-RDB. The difference of the HCV genotypes in Han and Korean was compared. The relationship between the HCV genotypes and HCV-RNA load, diabetes mellitus, severity of the diseases was analyzed.Results Compared with the incidence of type 2 diabetes mellitus in CHB patients and normal controls, the incidence of type 2 diabetes mellitus in CHC patients in Korean was 24.31% and in Han 26.85%. The difference in incidence between Korean and Han was not significant (χ2= 0.18, P>0.05). The incidence of type 2 diabetes mellitus in patients with CHC was 25.34% in total Han and Korean patients. However, the incidence of type 2 diabetes mellitus in patients with CHB was 9.38%. The difference was significant (χ2= 18.36, P<0.01). It also had a significant difference (χ2= 36.60, P<0.01) compared with the incidence of type 2 diabetes mellitus in the normal control group (9.84%). But compared with the CHB and the normal control group, the incidence of type 2 diabetes mellitus was not significant (χ2=1.09, P>0.05)The clinical features of CHC in patients with diabetes mellitus were analyzed. The positive cases of Anti-HCV antibody and HBsAg were 72 (8.46%) and 33 (3.88%) respectively in 851 patients with diabetes mellitus, whereas, they were 23 (2.94%) and 78 (9.97%) in 782 control people. The average alanine amino transferase (ALT) level and the positive rate of Anti-HCV antibody and HBsAg were compared between diabetes mellitus group and the control group. The difference was significant (tALT=2.91,χ2HCV=22.66,χ2HBsAg=22.96, P<0.01). The average ALT level and anti-HCV antibody positive rate in diabetes mellitus group were higher than those in the control group, however, HBsAg-positive rate was lower than that in non-diabetic medical group. Anti-HCV antibody positive rate (8.46%) in diabetes mellitus group was higher than HBsAg-positive rate (3.88%), the difference was significant (χ2= 14.66, P<0.01).But, anti-HCV antibody positive rate (2.94%) was lower than HBsAg-positive rate (9.97%) in non-diabetic medical group, the difference was also significant (χ2=30.86, P<0.01)The analysis of the clinical characteristics of diabetes mellitus in patients with CHC showed that when diabetes mellitus in patients with CHC was compared with non-diabetic CHC patients, there was no significant difference in age, gender, disease duration and body mass index (tage=0.89,χ2sex=2.33, tCourse=1.79, tBMI=1.36, P> 0.05). But, the serum ALT level and total bilirubin levels in diabetes mellitus patients with CHC were higher than those without diabetes mellitus (tALT=3.71, tTBIL=15.57, P<0.01).54.84% patients in this group of people were with diabetes family history. Compared with non-diabetes mellitus in patients with CHC there was statistically significant difference (χ2=95.02, P<0.001). R-glutamyl-GGT and albumin between the two groups was not significantly different (tGGT=0.69, tALB=1.50, P>0.05)The distribution of HCV genotypes of Korean and Han showed that in the 119 cases of patients with CHC, type 1b was 45.38% (54/119), type 2a was 39.49% (47/119), non-typed was 15.13% (18/119). Korean HCV genotypes showed that type 1b was 45.16%(28/62), type 2a was 38.71% (24/62), non-typed was 16.13% (10/62). Han HCV genotypes revealed that type lb was 45.61% (26/57), type 2a was 40.35% (23/57), non-typed was 14.14%(8/57). There was no significant difference in the distribution of each genotype between Han and Korean (p>0.05). The difference between genotype and the load of HCV-RNA was not significant (p> 0.05). The proportion of HCV lb type in the moderate, severe and mild CHC patients was statistically different (P<0.05)Conclusion (1) The incidence of type 2 diabetes mellitus in CHC patients is higher and the difference is not significant between Han and Korean. (2) The infection rate of HCV in diabetes mellitus group is higher than that in normal control group. It implies that there is some correlation between diabetes mellitus and HCV infection. (3) Diabetes mellitus in patients with CHC is relatively more serious; diabetes mellitus in patients with CHC with a family history are more complicated by diabetes. (4) The type lb is the most popular HCV genotype in Yanbian area of Jilin Province, China; type 2a is the second and there are still a few other genotypes. There is no significant difference in the distribution of HCV genotypes between Han and Korean. The HCV genotype has nothing to do with the load of HCV-RNA. The distribution of HCV genotypes in CHC patients with and without diabetes mellitus is not significantly different. Type 1b of HCV infection is relatively severe.
|
PDF Full Text Request