Retrospective Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Diabetes. Feb 15, 2024; 15(2): 220-231
Published online Feb 15, 2024. doi: 10.4239/wjd.v15.i2.220
Effect of viral hepatitis on type 2 diabetes: A Mendelian randomization study
Yun-Feng Yu, Gang Hu, Ke-Ke Tong, Xin-Yu Yang, Jing-Yi Wu, Rong Yu
Yun-Feng Yu, Gang Hu, Rong Yu, The First Hospital of Hunan University of Chinese Medicine, Changsha 410007, Hunan Province, China
Ke-Ke Tong, The Hospital of Hunan University of Traditional Chinese Medicine, Changde 415213, Hunan Province, China
Xin-Yu Yang, College of Chinese Medicine, Hunan University of Chinese Medicine, Changsha 410208, Hunan Province, China
Jing-Yi Wu, The Third Hospital of Zhejiang Chinese Medical University, Hangzhou 310005, Zhejiang Province, China
Co-first authors: Yun-Feng Yu and Gang Hu.
Author contributions: Yu YF conceived and designed the study; Yu YF and Hu G participated in data processing and statistical analysis; Yu YF, Hu G, Yang XY, and Wu JY drafted the manuscript; Hu G, Yang XY, Wu JY, and Yu R contributed to data analysis and interpretation; Yu YF, Tong KK, Yang XY, and Yu R supervised the review of the study; and all authors seriously revised and approved the final manuscript.
Supported by National Natural Science Foundation of China, No. U21A20411.
Institutional review board statement: Despite our study was an original research, this work just used genome-wide association studies statistics from public available databases for Mendelian randomization analysis, and we did not collect any new human data. As this study did not involve any human studies and/or animal experiments, the institutional review board approval was not required for our research.
Informed consent statement: Despite our study was an original research, this work just used genome-wide association studies statistics from public available databases for Mendelian randomization analysis, and we did not collect any new human data. As this study did not involve any human studies and/or animal experiments, the informed consent form was not required for our research.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: All GWAS data that support the findings of this study are openly available in the BioBank Japan Project (https://biobankjp.org/en/), European Bioinformatics Institute (https://www.ebi.ac.uk), and FinnGen (www.finngen.fi/fi).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Rong Yu, MD, The First Hospital of Hunan University of Chinese Medicine, No. 95 Shaoshan Middle Road, Yuhua District, Changsha 410007, Hunan Province, China. yurong196905@163.com
Received: November 11, 2023
Peer-review started: November 11, 2023
First decision: November 30, 2023
Revised: December 13, 2023
Accepted: January 17, 2024
Article in press: January 17, 2024
Published online: February 15, 2024
Processing time: 84 Days and 22.8 Hours
Abstract
BACKGROUND

The effects of viral hepatitis (VH) on type 2 diabetes (T2D) remain controversial.

AIM

To analyze the causal correlation between different types of VH and T2D using Mendelian randomization (MR).

METHODS

Single nucleotide polymorphisms of VH, chronic hepatitis B (CHB), chronic hepatitis C (CHC) and T2D were obtained from the BioBank Japan Project, European Bioinformatics Institute, and FinnGen. Inverse variance weighted, MR-Egger, and weighted median were used to test exposure-outcome associations. The MR-Egger intercept analysis and Cochran’s Q test were used to assess horizontal pleiotropy and heterogeneity, respectively. Leave-one-out sensitivity analysis was used to evaluate the robustness of the MR analysis results.

RESULTS

The MR analysis showed no significant causal relationship between VH and T2D in Europeans [odds ratio (OR) = 1.028; 95% confidence interval (CI): 0.995-1.062, P = 0.101]. There was a negative causal association between CHB and T2D among East Asians (OR = 0.949; 95%CI: 0.931-0.968, P < 0.001), while there was no significant causal association between CHC and T2D among East Asians (OR = 1.018; 95%CI: 0.959-1.081, P = 0.551). Intercept analysis and Cochran’s Q test showed no horizontal pleiotropy or heterogeneity (P > 0.05). Sensitivity analysis showed that the results were robust.

CONCLUSION

Among East Asians, CHB is associated with a reduced T2D risk, but this association is limited by HBV load and cirrhosis. Although VH among Europeans and CHC among East Asians are not associated with the risk of T2D, focusing on blood glucose in patients with CHC is still relevant for the early detection of T2D induced by CHC-mediated pathways of hepatic steatosis, liver fibrosis, and cirrhosis.

Keywords: Viral hepatitis; Chronic hepatitis B; Chronic hepatitis C; Type 2 diabetes; Mendelian randomization

Core Tip: The effects of hepatitis B and C on type 2 diabetes (T2D) remain controversial. The study aims to analyze the causal relationship of T2D with chronic hepatitis B (CHB) and chronic hepatitis C (CHC) by Mendelian randomization (MR). This MR analysis showed that in East Asians, CHC was not associated with T2D risk, whereas CHB was associated with a reduced risk of T2D. Although this MR analysis did not find a causal relationship between CHC and T2D, focusing on blood glucose in patients with CHC is still relevant, which helps early detect T2D induced by CHC-mediated other hepatic lesions.