Chronic hepatitis C tied to cardiovascular events in T2DM

In patients with type 2 diabetes mellitus (T2DM), chronic hepatitis C and fatty liver appear to worsen the risk of cardiovascular events, a recent Taiwan study has found.

Researchers conducted a nationwide retrospective cohort study of 152,709 adult T2DM patients (mean age 59.32 years, 50.35 percent women) who were enrolled in the National Health Insurance Diabetes Pay-for-Performance Program from 2008 to 2010. Follow-up was until the end of 2017.

Most of the participants had no liver-related disease (82.16 percent; n=125,437), while 6.66 percent (n=10,174), 3.31 percent (n=5,056), and 7.86 percent (n=12,006) had hepatitis B, hepatitis C, and fatty liver disease, respectively. Cardiovascular events occurred most frequently in hepatitis C diabetics, with an incidence rate of 79.91 per 1,000 person-years.

Incidence was likewise elevated in those with fatty liver (66.76 per 1,000 person-years).

Cox proportional hazards analysis showed that T2DM patients with fatty liver were at highest risk of cardiovascular disease (adjusted hazard ratio [HR], 1.10, 95 percent confidence interval [CI], 1.07–1.13), followed by those with hepatitis C (adjusted HR, 1.09, 95 percent CI, 1.03–1.12).

Other significant and independent risk factors for cardiovascular disease in this population included female sex, older age, a longer disease duration, higher bodyweight, more disease complications, and comorbidities such as hypertension and gout.

“Patients with diabetes and fatty liver or hepatitis C should be educated on the risk factors for cardiovascular disease actively and as early as possible. In addition to controlling the traditional risk factors, such as blood glucose and blood lipid control, weight loss, smoking cessation, and reduction of glucose variation are also important goals,” the researchers said.