There is increasing evidence of strong association between hepatitis C virus
(HCV) and diabetes mellitus particularly, non-insulin dependent diabetes
mellitus (NIDDM), the cause of which is still obscure. Auto-antibodies of
different types have been screened in patients with HCV. The presence of
islet cell antibodies (ICA) in diabetics has been the focus of widespread
interest This study was conducted to clarify the possible role of ICA in this
association and to find any correlation between ICA and other autoantibodies.
We studied 48 patients with HCV as diagnosed by RIBA II and PCR . Patients
were divided into group I (NIDDM group) and group II (Non diabetic group).
Group I comprised 14 males and 10 females with a mean age of 39.75 + 6
years. Group II comprised 16 males and 8 females with a mean age of 39.60
+ 5.8 years. Non of the patients received antiviral therapy. They were tested
for : Blood glucose , Liver functions ( ALT, AST, Alkaline Phosphatase,
Albumin and Pro thrombin time). The following non organ-specific
autoantibodies were screened :Anti-mitochondtial antibodies (AMA), Antismooth
muscle antibodies (ASMA), and Antinuclear antibodies (ANA) . Islet
cell antibodies (ICA) were screened in their sera by indirect
immunoflurescence test (lnova Lite, Research kit). The results of the study
showed relatively increased prevalence of ICA in group 1(33.3%) than in
group II (12.5%), but the difference was statistically non significant (P>0.05).
In group I AMA,ASMA, and ANA were positive in 8.3%, 41.6%, and 20.8%
respectively, while in group ll they were positive in 8.3%, 37.5% and 16.7%
respectively, with no statistical significant difference between both groups.
ICA correlated significantly with ASMA in both groups and with ANA only in
group II. No correlation was detected between ICA and AMA. Neither ICA nor
other studied auto-antibdies did correlate to any of the studied liver functions.
In Group I, ICA did no correlate to either patient's age, sex or family history of
diabetes. In conclusion: (1) The HCV-Diabetes Mellitus Link deserves
careful evaluation. (2) ICA alone could not explain the relatively high
incidence of diabetes mellitus in HCV patients. (3) ICA might be present in
the sera of HCV patients as a part of immune disturbances present in the
disease (3) There is a significant correlation between ICA and ASMA (4)
HCV might trigger an autoimmune phenomena that persist even after
cessation of the disease activity (5) Other possible mechanisms for HCVDiabetes
Mellitus Link might be: iron overload, metabolic effect, receptor
and/or post-receptor effect, viral pancreatitis or HLA association. |
