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Diabetes placed patients with CHC at increased risk for cirrhosis, decompensation
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Taiwanese patients with chronic hepatitis C virus infection and new-onset diabetes had a greater risk for cirrhosis and decompensated liver compared with patients without diabetes, according to study results.
Researchers used data from the Taiwanese National Health Insurance Research Database in identifying 2,132 adults with chronic hepatitis C virus (HCV) for their study. Patients with chronic HCV (CHC) and new-onset diabetes (n=424) and patients with CHC but not diabetes (n=1,708) were followed until cirrhosis or decompensation occurred, they withdrew from insurance or until December 2009.
Kaplan-Meier survival analysis revealed that standardized incidence ratios of cirrhosis and decompensation were higher among patients with CHC and new-onset diabetes who were aged 40 to 59 years, had not undergone CHC or diabetes treatment, and in those with or without hepatocellular carcinoma (HCC) compared with patients without diabetes. They also were higher in patients with comorbidity scores greater than 2 or less than 2 (cirrhosis) and had index scores of 1 or at least 3 (decompensation) vs. patients without diabetes.
Additionally, patients with CHC and new-onset diabetes had a higher relative risk for cirrhosis (RR=1.53; 95% CI, 1.11-2.11) and decompensation (RR=2.01; 95% CI, 1.07-3.79) compared with patients without diabetes.
Diabetes was found to be an independent predictor for cirrhosis (HR=2.505; 95% CI, 1.609-3.897) and decompensation (HR=3.56; 95% CI, 1.526-8.307), after adjusting for multivariables that included age, sex, HCC and comorbidity index.
“After adjustment … new-onset diabetes is still an independent predictor for cirrhosis development and its decompensation in CHC patients,” the researchers concluded. “CHC patients who develop diabetes during follow-up are at an increased risk of cirrhosis and its decompensation over time and should receive active management.”
Disclosure: The researchers report no relevant financial disclosures.
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