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Published in: Acta Diabetologica 4/2011

01-12-2011 | Original Article

HBV and HCV infection in type 2 diabetes mellitus: a survey in three diabetes units in different Italian areas

Authors: Valentina Soverini, Marcello Persico, Elisabetta Bugianesi, Gabriele Forlani, Federico Salamone, Mario Massarone, Vincenzo La Mura, Arianna Mazzotti, Alberto Bruno, Giulio Marchesini

Published in: Acta Diabetologica | Issue 4/2011

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Abstract

Viral infections and the metabolic syndrome may coexist in several individuals, due to the large prevalence of obesity and type 2 diabetes mellitus (T2DM). Antiviral therapy has changed the natural history of chronic viral hepatitis, but viral infection may remain undiagnosed in the absence of systematic screening. We determined the prevalence of HBV and/or HCV infection in an Italian cohort with T2DM (859 consecutive patients, 413 females) in three Italian centers: Turin, Bologna, and Naples. Screening for viral disease was coupled with the determination of parameters of metabolic syndrome. Fourteen patients were HBsAg-positive, 51 anti-HCV with a prevalence of genotype-1 infection in 58% of cases. Thirty cases had newly diagnosed viral markers, only one-third had already-diagnosed liver disease, 16 were being followed-up by a Liver Unit, and 9 cases had received antiviral treatment. Patients with viral markers had higher liver enzyme levels in comparison with virus-negative patients (P < 0.0001), whereas the prevalence of the metabolic syndrome was similar in the 2 groups. A positive correlation between BMI and alanine aminostransferase levels was only present in virus-negative cases, where the probability of enzyme levels above the upper limit of normal increased by 5% for unit of increase in BMI (OR: 1.05; 95% CI: 1.003–1.100, P = 0.037). In conclusion, the prevalence of HBV and HCV is non-negligible in patients with T2DM, but these cases may long remain undiagnosed. Elevated liver enzymes might be frequently disregarded in diabetes Units and ascribed to metabolic syndrome, thus excluding T2DM patients from specific disease-modifying antiviral treatment for hepatitis.
Literature
2.
go back to reference Jadoon NA, Shahzad MA, Yaqoob R, Hussain M, Ali N (2010) Seroprevalence of hepatitis C in type 2 diabetes: evidence for a positive association. Virol J 7:304PubMedCrossRef Jadoon NA, Shahzad MA, Yaqoob R, Hussain M, Ali N (2010) Seroprevalence of hepatitis C in type 2 diabetes: evidence for a positive association. Virol J 7:304PubMedCrossRef
3.
go back to reference Chen HF, Li CY, Chen P, See TT, Lee HY (2006) Seroprevalence of hepatitis B and C in type 2 diabetic patients. J Chin Med Assoc 69:146–152PubMedCrossRef Chen HF, Li CY, Chen P, See TT, Lee HY (2006) Seroprevalence of hepatitis B and C in type 2 diabetic patients. J Chin Med Assoc 69:146–152PubMedCrossRef
4.
go back to reference Kaabia N, Ben Jazia E, Slim I, Fodha I, Hachfi W, Gaha R, Khalifa M, Hadj Kilani A, Trabelsi H, Abdelaziz A, Bahri F, Letaief A (2009) Association of hepatitis C virus infection and diabetes in central Tunisia. World J Gastroenterol 15:2778–2781PubMedCrossRef Kaabia N, Ben Jazia E, Slim I, Fodha I, Hachfi W, Gaha R, Khalifa M, Hadj Kilani A, Trabelsi H, Abdelaziz A, Bahri F, Letaief A (2009) Association of hepatitis C virus infection and diabetes in central Tunisia. World J Gastroenterol 15:2778–2781PubMedCrossRef
5.
go back to reference Alberti A, Vario A, Ferrari A, Pistis R (2005) Review article: chronic hepatitis C–natural history and cofactors. Aliment Pharmacol Ther 22(Suppl 2):74–78PubMedCrossRef Alberti A, Vario A, Ferrari A, Pistis R (2005) Review article: chronic hepatitis C–natural history and cofactors. Aliment Pharmacol Ther 22(Suppl 2):74–78PubMedCrossRef
6.
go back to reference Hui JM, Sud A, Farrell GC, Bandara P, Byth K, Kench JG, McCaughan GW, George J (2003) Insulin resistance is associated with chronic hepatitis C virus infection and fibrosis progression [corrected]. Gastroenterology 125:1695–1704PubMedCrossRef Hui JM, Sud A, Farrell GC, Bandara P, Byth K, Kench JG, McCaughan GW, George J (2003) Insulin resistance is associated with chronic hepatitis C virus infection and fibrosis progression [corrected]. Gastroenterology 125:1695–1704PubMedCrossRef
7.
go back to reference Leandro G, Mangia A, Hui J, Fabris P, Rubbia-Brandt L, Colloredo G, Adinolfi LE, Asselah T, Jonsson JR, Smedile A, Terrault N, Pazienza V, Giordani MT, Giostra E, Sonzogni A, Ruggiero G, Marcellin P, Powell EE, George J, Negro F, The HCV MAID Study Group (2006) Relationship between steatosis, inflammation, and fibrosis in chronic hepatitis C: a meta-analysis of individual patient data. Gastroenterology 130:1346–1362CrossRef Leandro G, Mangia A, Hui J, Fabris P, Rubbia-Brandt L, Colloredo G, Adinolfi LE, Asselah T, Jonsson JR, Smedile A, Terrault N, Pazienza V, Giordani MT, Giostra E, Sonzogni A, Ruggiero G, Marcellin P, Powell EE, George J, Negro F, The HCV MAID Study Group (2006) Relationship between steatosis, inflammation, and fibrosis in chronic hepatitis C: a meta-analysis of individual patient data. Gastroenterology 130:1346–1362CrossRef
8.
go back to reference Aytug S, Reich D, Sapiro LE, Bernstein D, Begum N (2003) Impaired IRS-1/PI3-kinase signaling in patients with HCV: a mechanism for increased prevalence of type 2 diabetes. Hepatology 38:1384–1392PubMed Aytug S, Reich D, Sapiro LE, Bernstein D, Begum N (2003) Impaired IRS-1/PI3-kinase signaling in patients with HCV: a mechanism for increased prevalence of type 2 diabetes. Hepatology 38:1384–1392PubMed
9.
go back to reference Shintani Y, Fujie H, Miyoshi H, Tsutsumi T, Tsukamoto K, Kimura S, Moriya K, Koike K (2004) Hepatitis C virus infection and diabetes: direct involvement of the virus in the development of insulin resistance. Gastroenterology 126:840–848PubMedCrossRef Shintani Y, Fujie H, Miyoshi H, Tsutsumi T, Tsukamoto K, Kimura S, Moriya K, Koike K (2004) Hepatitis C virus infection and diabetes: direct involvement of the virus in the development of insulin resistance. Gastroenterology 126:840–848PubMedCrossRef
10.
go back to reference Bugianesi E, McCullough AJ, Marchesini G (2005) Insulin resistance: a metabolic pathway to chronic liver disease. Hepatology 42:987–1000PubMedCrossRef Bugianesi E, McCullough AJ, Marchesini G (2005) Insulin resistance: a metabolic pathway to chronic liver disease. Hepatology 42:987–1000PubMedCrossRef
11.
go back to reference Vanni E, Abate ML, Gentilcore E, Hickman I, Gambino R, Cassader M, Smedile A, Ferrannini E, Rizzetto M, Marchesini G, Gastaldelli A, Bugianesi E (2009) Sites and mechanisms of insulin resistance in nonobese, nondiabetic patients with chronic hepatitis C. Hepatology 50:697–706PubMedCrossRef Vanni E, Abate ML, Gentilcore E, Hickman I, Gambino R, Cassader M, Smedile A, Ferrannini E, Rizzetto M, Marchesini G, Gastaldelli A, Bugianesi E (2009) Sites and mechanisms of insulin resistance in nonobese, nondiabetic patients with chronic hepatitis C. Hepatology 50:697–706PubMedCrossRef
12.
go back to reference Kawaguchi T, Yoshida T, Harada M, Hisamoto T, Nagao Y, Ide T, Taniguchi E, Kumemura H, Hanada S, Maeyama M, Baba S, Koga H, Kumashiro R, Ueno T, Ogata H, Yoshimura A, Sata M (2004) Hepatitis C virus down-regulates insulin receptor substrates 1 and 2 through up-regulation of suppressor of cytokine signaling 3. Am J Pathol 165:1499–1508PubMedCrossRef Kawaguchi T, Yoshida T, Harada M, Hisamoto T, Nagao Y, Ide T, Taniguchi E, Kumemura H, Hanada S, Maeyama M, Baba S, Koga H, Kumashiro R, Ueno T, Ogata H, Yoshimura A, Sata M (2004) Hepatitis C virus down-regulates insulin receptor substrates 1 and 2 through up-regulation of suppressor of cytokine signaling 3. Am J Pathol 165:1499–1508PubMedCrossRef
13.
go back to reference Kawaguchi T, Ide T, Taniguchi E, Hirano E, Itou M, Sumie S, Nagao Y, Yanagimoto C, Hanada S, Koga H, Sata M (2007) Clearance of HCV improves insulin resistance, beta-cell function, and hepatic expression of insulin receptor substrate 1 and 2. Am J Gastroenterol 102:570–576PubMedCrossRef Kawaguchi T, Ide T, Taniguchi E, Hirano E, Itou M, Sumie S, Nagao Y, Yanagimoto C, Hanada S, Koga H, Sata M (2007) Clearance of HCV improves insulin resistance, beta-cell function, and hepatic expression of insulin receptor substrate 1 and 2. Am J Gastroenterol 102:570–576PubMedCrossRef
14.
go back to reference Persico M, Capasso M, Persico E, Svelto M, Russo R, Spano D, Croce L, La Mura V, Moschella F, Masutti F, Torella R, Tiribelli C, Iolascon A (2007) Suppressor of cytokine signaling 3 (SOCS3) expression and hepatitis C virus-related chronic hepatitis: insulin resistance and response to antiviral therapy. Hepatology 46:1009–1015PubMedCrossRef Persico M, Capasso M, Persico E, Svelto M, Russo R, Spano D, Croce L, La Mura V, Moschella F, Masutti F, Torella R, Tiribelli C, Iolascon A (2007) Suppressor of cytokine signaling 3 (SOCS3) expression and hepatitis C virus-related chronic hepatitis: insulin resistance and response to antiviral therapy. Hepatology 46:1009–1015PubMedCrossRef
15.
go back to reference Persico M, Russo R, Persico E, Svelto M, Spano D, Andolfo I, La Mura V, Capasso M, Tiribelli C, Torella R, Iolascon A (2009) SOCS3 and IRS-1 gene expression differs between genotype 1 and genotype 2 hepatitis C virus-infected HepG2 cells. Clin Chem Lab Med 47:1217–1225PubMedCrossRef Persico M, Russo R, Persico E, Svelto M, Spano D, Andolfo I, La Mura V, Capasso M, Tiribelli C, Torella R, Iolascon A (2009) SOCS3 and IRS-1 gene expression differs between genotype 1 and genotype 2 hepatitis C virus-infected HepG2 cells. Clin Chem Lab Med 47:1217–1225PubMedCrossRef
16.
go back to reference Hsu CS, Liu CJ, Liu CH, Wang CC, Chen CL, Lai MY, Chen PJ, Kao JH, Chen DS (2008) High hepatitis C viral load is associated with insulin resistance in patients with chronic hepatitis C. Liver Int 28:271–277PubMedCrossRef Hsu CS, Liu CJ, Liu CH, Wang CC, Chen CL, Lai MY, Chen PJ, Kao JH, Chen DS (2008) High hepatitis C viral load is associated with insulin resistance in patients with chronic hepatitis C. Liver Int 28:271–277PubMedCrossRef
17.
go back to reference Harrison SA (2006) Correlation between insulin resistance and hepatitis C viral load. Hepatology 43:1168–1169 Author replyPubMedCrossRef Harrison SA (2006) Correlation between insulin resistance and hepatitis C viral load. Hepatology 43:1168–1169 Author replyPubMedCrossRef
18.
go back to reference Yoneda M, Saito S, Ikeda T, Fujita K, Mawatari H, Kirikoshi H, Inamori M, Nozaki Y, Akiyama T, Takahashi H, Abe Y, Kubota K, Iwasaki T, Terauchi Y, Togo S, Nakajima A (2007) Hepatitis C virus directly associates with insulin resistance independent of the visceral fat area in nonobese and nondiabetic patients. J Viral Hepat 14:600–607PubMedCrossRef Yoneda M, Saito S, Ikeda T, Fujita K, Mawatari H, Kirikoshi H, Inamori M, Nozaki Y, Akiyama T, Takahashi H, Abe Y, Kubota K, Iwasaki T, Terauchi Y, Togo S, Nakajima A (2007) Hepatitis C virus directly associates with insulin resistance independent of the visceral fat area in nonobese and nondiabetic patients. J Viral Hepat 14:600–607PubMedCrossRef
19.
go back to reference Browning JD, Horton JD (2004) Molecular mediators of hepatic steatosis and liver injury. J Clin Invest 114:147–152PubMed Browning JD, Horton JD (2004) Molecular mediators of hepatic steatosis and liver injury. J Clin Invest 114:147–152PubMed
20.
go back to reference Sanyal AJ, Chand N, Comar K, Mishahi F (2004) Hyperinsulinaemia blocks the inhibition of hepatitis C virus (HCV) replication by interferon: a potential mechanism for failure of interferon therapy in subjects with HCV and non-alcoholic fatty liver disease. Hepatology 40:179ACrossRef Sanyal AJ, Chand N, Comar K, Mishahi F (2004) Hyperinsulinaemia blocks the inhibition of hepatitis C virus (HCV) replication by interferon: a potential mechanism for failure of interferon therapy in subjects with HCV and non-alcoholic fatty liver disease. Hepatology 40:179ACrossRef
21.
go back to reference Romero-Gomez M, Fernandez-Rodriguez CM, Andrade RJ, Diago M, Alonso S, Planas R, Sola R, Pons JA, Salmeron J, Barcena R, Perez R, Carmona I, Duran S (2008) Effect of sustained virological response to treatment on the incidence of abnormal glucose values in chronic hepatitis C. J Hepatol 48:721–727PubMedCrossRef Romero-Gomez M, Fernandez-Rodriguez CM, Andrade RJ, Diago M, Alonso S, Planas R, Sola R, Pons JA, Salmeron J, Barcena R, Perez R, Carmona I, Duran S (2008) Effect of sustained virological response to treatment on the incidence of abnormal glucose values in chronic hepatitis C. J Hepatol 48:721–727PubMedCrossRef
22.
go back to reference Arase Y, Suzuki F, Suzuki Y, Akuta N, Kobayashi M, Kawamura Y, Yatsuji H, Sezaki H, Hosaka T, Hirakawa M, Ikeda K, Kumada H (2009) Sustained virological response reduces incidence of onset of type 2 diabetes in chronic hepatitis C. Hepatology 49:739–744PubMedCrossRef Arase Y, Suzuki F, Suzuki Y, Akuta N, Kobayashi M, Kawamura Y, Yatsuji H, Sezaki H, Hosaka T, Hirakawa M, Ikeda K, Kumada H (2009) Sustained virological response reduces incidence of onset of type 2 diabetes in chronic hepatitis C. Hepatology 49:739–744PubMedCrossRef
23.
go back to reference Giordanino C, Bugianesi E, Smedile A, Ciancio A, Abate ML, Olivero A, Pellicano R, Cassader M, Gambino R, Bo S, Ciccone G, Rizzetto M, Saracco G (2008) Incidence of type 2 diabetes mellitus and glucose abnormalities in patients with chronic hepatitis C infection by response to treatment: results of a cohort study. Am J Gastroenterol 103:2481–2487PubMedCrossRef Giordanino C, Bugianesi E, Smedile A, Ciancio A, Abate ML, Olivero A, Pellicano R, Cassader M, Gambino R, Bo S, Ciccone G, Rizzetto M, Saracco G (2008) Incidence of type 2 diabetes mellitus and glucose abnormalities in patients with chronic hepatitis C infection by response to treatment: results of a cohort study. Am J Gastroenterol 103:2481–2487PubMedCrossRef
24.
go back to reference Mason AL, Lau JY, Hoang N, Qian K, Alexander GJ, Xu L, Guo L, Jacob S, Regenstein FG, Zimmerman R, Everhart JE, Wasserfall C, Maclaren NK, Perrillo RP (1999) Association of diabetes mellitus and chronic hepatitis C virus infection. Hepatology 29:328–333PubMedCrossRef Mason AL, Lau JY, Hoang N, Qian K, Alexander GJ, Xu L, Guo L, Jacob S, Regenstein FG, Zimmerman R, Everhart JE, Wasserfall C, Maclaren NK, Perrillo RP (1999) Association of diabetes mellitus and chronic hepatitis C virus infection. Hepatology 29:328–333PubMedCrossRef
25.
go back to reference Sangiorgio L, Attardo T, Gangemi R, Rubino C, Barone M, Lunetta M (2000) Increased frequency of HCV and HBV infection in type 2 diabetic patients. Diabetes Res Clin Pract 48:147–151PubMedCrossRef Sangiorgio L, Attardo T, Gangemi R, Rubino C, Barone M, Lunetta M (2000) Increased frequency of HCV and HBV infection in type 2 diabetic patients. Diabetes Res Clin Pract 48:147–151PubMedCrossRef
26.
go back to reference Picerno I, Di Pietro A, Spataro P, Di Benedetto A, Romano G, Scoglio ME (2002) Is diabetes mellitus a risk factor for HCV infection? Ann Ig 14:473–477PubMed Picerno I, Di Pietro A, Spataro P, Di Benedetto A, Romano G, Scoglio ME (2002) Is diabetes mellitus a risk factor for HCV infection? Ann Ig 14:473–477PubMed
27.
go back to reference Balogun WO, Adeleye JO, Akinlade KS, Kuti M, Otegbayo JA (2006) Low prevalence of hepatitis-C viral seropositivity among patients with type-2 diabetes mellitus in a tertiary hospital. J Natl Med Assoc 98:1805–1808PubMed Balogun WO, Adeleye JO, Akinlade KS, Kuti M, Otegbayo JA (2006) Low prevalence of hepatitis-C viral seropositivity among patients with type-2 diabetes mellitus in a tertiary hospital. J Natl Med Assoc 98:1805–1808PubMed
28.
go back to reference Gulcan A, Gulcan E, Toker A, Bulut I, Akcan Y (2008) Evaluation of risk factors and seroprevalence of hepatitis B and C in diabetic patients in Kutahya, Turkey. J Investig Med 56:858–863PubMed Gulcan A, Gulcan E, Toker A, Bulut I, Akcan Y (2008) Evaluation of risk factors and seroprevalence of hepatitis B and C in diabetic patients in Kutahya, Turkey. J Investig Med 56:858–863PubMed
29.
go back to reference Forlani G, Di Bonito P, Mannucci E, Capaldo B, Genovese S, Orrasch M, Scaldaferri L, Di Bartolo P, Melandri P, Dei Cas A, Zavaroni I, Marchesini G (2008) Prevalence of elevated liver enzymes in Type 2 diabetes mellitus and its association with the metabolic syndrome. J Endocrinol Invest 31:146–152PubMed Forlani G, Di Bonito P, Mannucci E, Capaldo B, Genovese S, Orrasch M, Scaldaferri L, Di Bartolo P, Melandri P, Dei Cas A, Zavaroni I, Marchesini G (2008) Prevalence of elevated liver enzymes in Type 2 diabetes mellitus and its association with the metabolic syndrome. J Endocrinol Invest 31:146–152PubMed
30.
go back to reference Simo R, Hernandez C, Genesca J, Jardi R, Mesa J (1996) High prevalence of hepatitis C virus infection in diabetic patients. Diabetes Care 19:998–1000PubMedCrossRef Simo R, Hernandez C, Genesca J, Jardi R, Mesa J (1996) High prevalence of hepatitis C virus infection in diabetic patients. Diabetes Care 19:998–1000PubMedCrossRef
31.
go back to reference Cadranel JF, Di Martino V, Lambrey G, Mourlhon C, Nalet B, Anciaux ML, Richard C, Bigue JP, Barjon JN, Bories C, Barbare JC, Halimi C, Ribiere O, Eugene C, Pauwels A, Jeanne S, Donato L, Dumouchel P, Pariente A, Duverlie G, Devergie B, Arlot S, Capron D (2008) Prevalence of hepatitis C infection and risk factors in hospitalized diabetic patients: results of a cross-sectional study. Eur J Gastroenterol Hepatol 20:829–836PubMedCrossRef Cadranel JF, Di Martino V, Lambrey G, Mourlhon C, Nalet B, Anciaux ML, Richard C, Bigue JP, Barjon JN, Bories C, Barbare JC, Halimi C, Ribiere O, Eugene C, Pauwels A, Jeanne S, Donato L, Dumouchel P, Pariente A, Duverlie G, Devergie B, Arlot S, Capron D (2008) Prevalence of hepatitis C infection and risk factors in hospitalized diabetic patients: results of a cross-sectional study. Eur J Gastroenterol Hepatol 20:829–836PubMedCrossRef
32.
go back to reference Spada E, Mele A, Ciccozzi M, Tosti ME, Bianco E, Szklo A, Ragni P, Gallo G, Balocchini E, Sangalli M, Lopalco PL, Moiraghi A, Stroffolini T (2001) Changing epidemiology of parenterally transmitted viral hepatitis: results from the hepatitis surveillance system in Italy. Dig Liver Dis 33:778–784PubMedCrossRef Spada E, Mele A, Ciccozzi M, Tosti ME, Bianco E, Szklo A, Ragni P, Gallo G, Balocchini E, Sangalli M, Lopalco PL, Moiraghi A, Stroffolini T (2001) Changing epidemiology of parenterally transmitted viral hepatitis: results from the hepatitis surveillance system in Italy. Dig Liver Dis 33:778–784PubMedCrossRef
33.
go back to reference Gaeta GB, Stornaiuolo G, Precone DF, Lobello S, Chiaramonte M, Stroffolini T, Colucci G, Rizzetto M (2003) Epidemiological and clinical burden of chronic hepatitis B virus/hepatitis C virus infection. A multicenter Italian study. J Hepatol 39:1036–1041PubMedCrossRef Gaeta GB, Stornaiuolo G, Precone DF, Lobello S, Chiaramonte M, Stroffolini T, Colucci G, Rizzetto M (2003) Epidemiological and clinical burden of chronic hepatitis B virus/hepatitis C virus infection. A multicenter Italian study. J Hepatol 39:1036–1041PubMedCrossRef
34.
go back to reference Bellentani S, Tiribelli C (2001) The spectrum of liver disease in the general population: lesson from the Dionysos study. J Hepatol 35:531–537PubMedCrossRef Bellentani S, Tiribelli C (2001) The spectrum of liver disease in the general population: lesson from the Dionysos study. J Hepatol 35:531–537PubMedCrossRef
35.
go back to reference Stroffolini T, Sagnelli E, Almasio P, Ferrigno L, Craxi A, Mele A (2004) Characteristics of liver cirrhosis in Italy: results from a multicenter national study. Dig Liver Dis 36:56–60PubMedCrossRef Stroffolini T, Sagnelli E, Almasio P, Ferrigno L, Craxi A, Mele A (2004) Characteristics of liver cirrhosis in Italy: results from a multicenter national study. Dig Liver Dis 36:56–60PubMedCrossRef
36.
go back to reference Stroffolini T, Chiaramonte M, Craxi A, Franco E, Rapicetta M, Trivello R, De Mattia D, Mura I, Giammanco A, Rigo G et al (1991) Baseline sero-epidemiology of hepatitis B virus infection in children and teenagers in Italy. A survey before mass hepatitis B vaccination. J Infect 22:191–199PubMedCrossRef Stroffolini T, Chiaramonte M, Craxi A, Franco E, Rapicetta M, Trivello R, De Mattia D, Mura I, Giammanco A, Rigo G et al (1991) Baseline sero-epidemiology of hepatitis B virus infection in children and teenagers in Italy. A survey before mass hepatitis B vaccination. J Infect 22:191–199PubMedCrossRef
37.
go back to reference Stroffolini T (2005) The changing pattern of hepatitis B virus infection over the past three decades in Italy. Dig Liver Dis 37:622–627PubMedCrossRef Stroffolini T (2005) The changing pattern of hepatitis B virus infection over the past three decades in Italy. Dig Liver Dis 37:622–627PubMedCrossRef
38.
go back to reference Marchesini G, Forlani G, Rossi E, Berti A, De Rosa M (2010) The direct economic cost of pharmacologically-treated diabetes in Italy-2006. The ARNO observatory. Nutr Metab Cardiovasc Dis (in press) Marchesini G, Forlani G, Rossi E, Berti A, De Rosa M (2010) The direct economic cost of pharmacologically-treated diabetes in Italy-2006. The ARNO observatory. Nutr Metab Cardiovasc Dis (in press)
39.
go back to reference Binkin N, Fontana G, Lamberti A, Cattaneo C, Baglio G, Perra A, Spinelli A (2010) A national survey of the prevalence of childhood overweight and obesity in Italy. Obes Rev 11:2–10PubMedCrossRef Binkin N, Fontana G, Lamberti A, Cattaneo C, Baglio G, Perra A, Spinelli A (2010) A national survey of the prevalence of childhood overweight and obesity in Italy. Obes Rev 11:2–10PubMedCrossRef
40.
go back to reference Manco M, Giordano U, Turchetta A, Fruhwirth R, Ancinelli M, Marcellini M, Nobili V (2009) Insulin resistance and exercise capacity in male children and adolescents with non-alcholic fatty liver disease. Acta Diabetol 46:97–104PubMedCrossRef Manco M, Giordano U, Turchetta A, Fruhwirth R, Ancinelli M, Marcellini M, Nobili V (2009) Insulin resistance and exercise capacity in male children and adolescents with non-alcholic fatty liver disease. Acta Diabetol 46:97–104PubMedCrossRef
41.
go back to reference Fabris P, Baldo V, Baldovin T, Bellotto E, Rassu M, Trivello R, Tramarin A, Tositti G, Floreani A (2008) Changing epidemiology of HCV and HBV infections in Northern Italy: a survey in the general population. J Clin Gastroenterol 42:527–532PubMedCrossRef Fabris P, Baldo V, Baldovin T, Bellotto E, Rassu M, Trivello R, Tramarin A, Tositti G, Floreani A (2008) Changing epidemiology of HCV and HBV infections in Northern Italy: a survey in the general population. J Clin Gastroenterol 42:527–532PubMedCrossRef
42.
go back to reference Seeff LB, Ghany MG (2010) Management of untreated and nonresponder patients with chronic hepatitis C. Semin Liver Dis 30:348–360PubMedCrossRef Seeff LB, Ghany MG (2010) Management of untreated and nonresponder patients with chronic hepatitis C. Semin Liver Dis 30:348–360PubMedCrossRef
43.
go back to reference Lagiou P, Kuper H, Stuver SO, Tzonou A, Trichopoulos D, Adami HO (2000) Role of diabetes mellitus in the etiology of hepatocellular carcinoma. J Natl Cancer Inst 92:1096–1099PubMedCrossRef Lagiou P, Kuper H, Stuver SO, Tzonou A, Trichopoulos D, Adami HO (2000) Role of diabetes mellitus in the etiology of hepatocellular carcinoma. J Natl Cancer Inst 92:1096–1099PubMedCrossRef
44.
go back to reference Pollak M (2008) Insulin and insulin-like growth factor signalling in neoplasia. Nat Rev Cancer 8:915–928PubMedCrossRef Pollak M (2008) Insulin and insulin-like growth factor signalling in neoplasia. Nat Rev Cancer 8:915–928PubMedCrossRef
45.
go back to reference Moucari R, Asselah T, Cazals-Hatem D, Voitot H, Boyer N, Ripault MP, Sobesky R, Martinot-Peignoux M, Maylin S, Nicolas-Chanoine MH, Paradis V, Vidaud M, Valla D, Bedossa P, Marcellin P (2008) Insulin resistance in chronic hepatitis C: association with genotypes 1 and 4, serum HCV RNA level, and liver fibrosis. Gastroenterology 134:416–423PubMedCrossRef Moucari R, Asselah T, Cazals-Hatem D, Voitot H, Boyer N, Ripault MP, Sobesky R, Martinot-Peignoux M, Maylin S, Nicolas-Chanoine MH, Paradis V, Vidaud M, Valla D, Bedossa P, Marcellin P (2008) Insulin resistance in chronic hepatitis C: association with genotypes 1 and 4, serum HCV RNA level, and liver fibrosis. Gastroenterology 134:416–423PubMedCrossRef
46.
go back to reference Marchesini G, Brizi M, Morselli-Labate AM, Bianchi G, Bugianesi E, McCullough AJ, Forlani G, Melchionda N (1999) Association of nonalcoholic fatty liver disease with insulin resistance. Am J Med 107:450–455PubMedCrossRef Marchesini G, Brizi M, Morselli-Labate AM, Bianchi G, Bugianesi E, McCullough AJ, Forlani G, Melchionda N (1999) Association of nonalcoholic fatty liver disease with insulin resistance. Am J Med 107:450–455PubMedCrossRef
Metadata
Title
HBV and HCV infection in type 2 diabetes mellitus: a survey in three diabetes units in different Italian areas
Authors
Valentina Soverini
Marcello Persico
Elisabetta Bugianesi
Gabriele Forlani
Federico Salamone
Mario Massarone
Vincenzo La Mura
Arianna Mazzotti
Alberto Bruno
Giulio Marchesini
Publication date
01-12-2011
Publisher
Springer Milan
Published in
Acta Diabetologica / Issue 4/2011
Print ISSN: 0940-5429
Electronic ISSN: 1432-5233
DOI
https://doi.org/10.1007/s00592-011-0293-x

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