Clinical features of patients with type 2 diabetes mellitus and hepatitis C infection

Machine learning for predicting hepatitis B or C virus infection in diabetic patients

Highly prevalent hepatitis B and hepatitis C virus (HBV and HCV) infections have been reported among individuals with diabetes. Given the frequently asymptomatic nature of hepatitis and the challenges associated with screening in some vulnerable populations such as diabetes patients, we conducted an investigation into the performance of various machine learning models for the identification of hepatitis in diabetic patients while also evaluating the significance of features. Analyzing NHANES data from 2013 to 2018, machine learning models were evaluated; random forest (RF), support vector machine (SVM), eXtreme Gradient Boosting (XGBoost), and least absolute shrinkage and selection operator (LASSO) along with stacked ensemble model. We performed hyperparameter tuning to improve the performance of the model, and selected important predictors using the best performance model. LASSO showed the highest predictive performance (AUC-ROC = 0.810) rather than other models. Illicit drug use, poverty, and race were highly ranked as predictive factors for developing hepatitis in diabetes patients. Our study demonstrated that a machine-learning-based model performed optimally in the detection of hepatitis among diabetes patients, achieving high performance. Furthermore, models and predictors evaluated from the current study, we expect, could be supportive information for developing screening or treatment methods for hepatitis care in diabetes patients.

Prevalence of diabetic retinopathy in Brazil: a systematic review with meta-analysis

AIMS

To evaluate the prevalence of diabetic retinopathy (DR) in Brazilian adults with diabetes mellitus via a systematic review with meta-analysis.

METHODS

A systematic review using PubMed, EMBASE, and Lilacs was conducted, searching for studies published up to February 2022. Random effect meta-analysis was performed to estimate the DR prevalence.

RESULTS

We included 72 studies (n = 29,527 individuals). Among individuals with diabetes in Brazil, DR prevalence was 36.28% (95% CI 32.66-39.97, I2 98%). Diabetic retinopathy prevalence was highest in patients with longer duration of diabetes and in patients from Southern Brazil.

CONCLUSION

This review shows a similar prevalence of DR as compared to other low- and middle-income countries. However, the high heterogeneity observed-expected in systematic reviews of prevalence-raises concerns about the interpretation of these results, suggesting the need for multicenter studies with representative samples and standardized methodology.

An Overview of Diabetes Mellitus in Egypt and the Significance of Integrating Preventive Cardiology in Diabetes Management

In Egypt, diabetes mellitus (DM) is a significant public health concern, and the disease is considered a modern pandemic throughout the world. The incidence of diabetes is steadily climbing, which is causing grave concern. As a result, it is essential to take into consideration the risk factors that are pervasive in Egyptian society and have led to the worsening of this problem. These risk factors include sedentary lifestyles, obesity, hepatitis C infections, pesticides, smoking, and bad cultural habits. In this review, we aim to demonstrate the possible solutions to fight diabetes mellitus and overcome its serious health and socioeconomic burdens in Egypt. A multidisciplinary, team-based approach is highly recommended in diabetes management. Primary care physicians, endocrinologists, nephrologists, and preventive cardiologists all play a crucial role in providing the highest possible level of care to diabetic patients by collaborating closely with one another. The assessment of cardiovascular risk and the prevention of life-threatening cardiovascular events, common among diabetic patients, warrant the introduction of preventive cardiology, a new and significant concept in diabetes care that demands adoption. The integration of preventive cardiology into the treatment of diabetic patients is expected to significantly cut down the morbidity and mortality rates associated with diabetes mellitus and provide them with a better quality of life.

Hepatitis B And Hepatitis C Viral Infections And Associated Factors Among Patients With Diabetes Visiting Gondar Referral Teaching Hospital, Northwest Ethiopia: A Comparative Cross-Sectional Study

Background

The liver is the major site of Hepatitis B virus and Hepatitis C virus replications. Patients with diabetes tend to be at an increased risk for developing various forms of liver diseases. The infection of the liver can cause or exacerbate diabetes. On the other hand, diabetes can cause or intensify the severity of liver infection. This comparative cross-sectional study was conducted with the aim to determine the prevalence of Hepatitis B and Hepatitis C virus infections and associated factors among patients with diabetes visiting the University of Gondar referral teaching hospital, northwest Ethiopia.

Results

Out of the 610 participants (305 patients with diabetes, 305 people with no diabetes) of the study, 65 (10.7%) were positive for Hepatitis infections, of whom 44 (14.4%) and 21 (6.9%) were positive for at least one of the viruses in patients with diabetes and people with no diabetes, respectively. Out of the diabetic and non-diabetic groups of the study, 26 (8.5%) and 14 (4.6%) (95% CI, 0.96-4.02) were positive for Hepatitis B virus, respectively, while 23 (7.5%) and 7 (2.3%) (95% CI, 1.46-8.68) of the diabetes and non-diabetic groups were positive for Hepatitis C virus, respectively. History of blood transfusion (95% CI, 1.36-12.71) and unprotected sex (95% CI, 1.25-10.15) were significantly associated with Hepatitis B virus infection, while the type of diabetes (95% CI, 1.25-10.89) was associated with anti-Hepatitis C virus positivity.

Conclusion

Positivity for Hepatitis C virus was significantly associated with Type II diabetes. Blood transfusion and unprotected sex were risk factors for Hepatitis B virus infections. Further studies that elaborate temporal associations and find out explanations for the relationship between diabetes and Hepatitis C viral infections are of paramount importance.

Comorbid hepatitis C does not modulate prevalence or severity of diabetic retinopathy

Purpose

There are limited and conflicting data regarding the impact of comorbid hepatitis C virus (HCV) infection on diabetic retinopathy (DR). This study sought to compare the prevalence and severity of DR among patients with diabetes mellitus (DM) with and without HCV.

Patients and methods

This was a retrospective, case–control study of patients with DM comparing 120 patients with comorbid HCV and 120 age-matched controls. DR prevalence and several measures of severity were compared between groups. Subgroup analyses were performed among HCV patients with cirrhosis, comorbid HIV, or history of treatment with interferon. Statistical analysis for between-group comparisons utilized both univariate and multivariate analyses.

Results

Cases and controls exhibited similar baseline characteristics: average hemoglobin A1c, DM duration, and age (p>0.05). Among cases and controls, there was no difference in DR prevalence (35.8% versus 42.5%, respectively, p=0.29) or severity (p>0.05). Within the HCV subgroup, DR severity was reduced in patients with HIV or cirrhosis. However, multivariate analysis identified reduced DM duration in these subgroups as the primary contributor to lesser DR severity, rather than HIV or cirrhosis.

Conclusion

In this study, comorbid HCV did not modulate the prevalence or severity of DR among patients with DM. These findings may inform clinical monitoring among HCV-positive diabetics undergoing ophthalmic evaluation.

Prevalence of hepatitis B and hepatitis C among diabetes mellitus type 2 individuals

Diabetes mellitus type 2 (DM2) patients have higher risk to be infected with parenterally transmitted viruses, like hepatitis B or C virus. This study aims to determine HBV and HCV infection prevalence in DM2 patients from Northeast and Southeast Brazil. A total of 537 DM2 patients were included, 194 (36.12%) males and 343 (63.87%) females, with mean age of 57.13±11.49 years. HBV and HCV markers were determined using serological and molecular analysis, and risk factors were evaluated in a subgroup from Southeast (n = 84). Two HBV acute (HBsAg+/anti-HBc -) and one HBV chronic case (HBsAg+/anti-HBc+) were found. Six individuals (1.1%) were isolated anti-HBc, 37 (6.9%) had HBV infection resolved (anti-HBc+/anti-HBs+), 40 (7.4%) were considered HBV vaccinated (anti-HBc-/anti-HBs+). Thirteen patients (2.42%) had anti-HCV and 7 of them were HCV RNA+. In the subgroup, anti-HBc positivity was associated to age and anti-HCV positivity was associated to age, time of diabetes diagnosis, total bilirubin, indirect bilirubin, alkaline phosphatase at bivariate analysis, but none of them was statistically significant at multivariate analysis. As conclusion, low prevalence of HBV and high prevalence HCV was found in DM2 patients.

Prevalence of serological markers for hepatitis and potential associated factors in patients with diabetes mellitus

Objective:

to estimate the prevalence of serological markers for hepatitis B and C in patients with diabetes mellitus and analyze potential associated factors.

Method:

a cross-sectional study with 255 patients with diabetes mellitus. Demographic, clinical, and risk behavior factors for hepatitis B and C were selected. The markers HBsAg, Anti-HBc IgG, Anti-HBc IgM, Anti-HBs, and Anti-HCV were investigated. A questionnaire and venous blood collection and inferential statistical analysis were used.

Results:

16.8% of the patients had a total reactive Anti-HBc marker, 8.2% an isolated Anti-HBs, and 75% were non-reactive for all hepatitis B markers. No case of reactive HBsAg was found and 3.3% of the patients had a reactive anti-HCV marker. The prevalence of prior hepatitis B virus infection was directly associated with the time of diabetes mellitus and the prevalence of hepatitis C virus infection was not associated with the investigated variables. The prevalence of hepatitis B and C infection in patients with diabetes mellitus was higher when compared to the national, with values of 16.8% and 3.3%, respectively.

Conclusion:

the results suggest that patients with diabetes are a population of higher vulnerability to hepatitis B and C, leading to the adoption of preventive measures of their occurrence.

Epidemiology of and Risk Factors for Type 2 Diabetes in Egypt

BACKGROUND

Diabetes is a fast-growing health problem in Egypt with a significant impact on morbidity, mortality, and health care resources. Currently, the prevalence of type 2 diabetes (T2D) in Egypt is around 15.6% of all adults aged 20 to 79.

OBJECTIVE

To describe the epidemiology, principal causes, associated risk factors, cultural aspects, and challenges that may contribute to the rapid rise in T2D in Egypt.

METHODS

Review of papers in PubMed and relevant gray literature.

FINDINGS

The International Diabetes Federation (IDF) has identified Egypt as the ninth leading country in the world for the number of patients with T2D. The prevalence of T2D in Egypt was almost tripled over the last 2 decades. This sharp rise could be attributed to either an increased pattern of the traditional risk factors for T2D such as obesity and physical inactivity and change in eating pattern or other risk factors unique to Egypt. These include increased exposure to environmental risk factors like pesticides and increased prevalence of chronic hepatitis C.

CONCLUSIONS

Prevention, early identification, and effective intervention are integral components of effective T2D care in Egypt. These strategies may reduce the expanding economic burden associated with T2D care.

Epidemiology of hepatitis C virus in Iran

In Iran, the prevalence of hepatitis C virus (HCV) infection is relatively low according to the population-based epidemiological studies. However, the epidemiology of HCV is changing and the rate of HCV infection is increasing due to the growth in the number of injecting drug users in the society. In addition, a shift has occurred in the distribution pattern of HCV genotypes among HCV-infected patients in Iran. Genotype 1a is the most prevalent genotype in Iran, but in recent years, an increase in the frequency of 3a and a decrease in 1a and 1b have been reported. These variations in the epidemiology of HCV reflect differences in the routes of transmission, status of public health, lifestyles, and risk factors in different groups and geographic regions of Iran. Health policy makers should consider these differences to establish better strategies for control and prevention of HCV infection. Therefore, this review was conducted to present a clear view regarding the current epidemiology of HCV infection in Iran.