Association of HCV with diabetes mellitus: an Egyptian case-control study

<p>Abstract</p> <p>Background</p> <p>The highest Hepatitis C Virus (HCV) prevalence in the world occurs in Egypt. Several studies from different parts of the world have found that 13% to 33% of patients with chronic HCV have associated diabetes, mostly type II Diabetes Mellitus (DM). In Egypt the prevalence of DM is 25.4% among HCV patients. Therefore, it is important to identify the magnitude of the problem of diabetes in order to optimize the treatment of chronic hepatitis C.</p> <p>Methods</p> <p>The objective of this case-control study was to evaluate the prevalence of DM and other extrahepatic (EH) manifestations among patients with different HCV morbidity stages including asymptomatic, chronic hepatic and cirrhotic patients. In this study, 289 HCV patients older than 18 were selected as cases. Also, 289 healthy controls were included. Laboratory investigations including Liver Function tests (LFT) and blood glucose level were done. Also serological assays including cryoglobulin profile, rheumatoid factor, antinuclear antibody, HCV-PCR were performed.</p> <p>Results</p> <p>Out of 289 HCV cases, 40 (13.84%) were diabetic. Out of 289 healthy controls, 12 (4.15%) were diabetic. It was found that the diabetic HCV group mean age was [48.1 (± 9.2)]. Males and urbanians represented 72.5% and 85% respectively. Lower level of education was manifested in 52.5% and 87.5% were married. In the nondiabetic HCV group mean age was [40.7 (± 10.4)]. Males and urbanians represented 71.5% and 655% respectively. secondary and higher level of education was attained in 55.4% and 76.7% were married. Comparing between the diabetic HCV group and the non diabetic HCV group, age, residence and alcohol drinking were the only significant factors affecting the incidence of diabetes between the two groups. There was no significant difference regarding sonar findings although cirrhosis was more prevalent among diabetic HCV cases and the fibrosis score was higher in diabetic HCV patients than among the non diabetic HCV cases.</p> <p>Conclusion</p> <p>The diabetic patients in the HCV group were older, more likely to have a history of alcohol drinking than the non diabetic HCV cases. Age and alcohol drinking are factors that could potentially contribute to the development of type 2 diabetes. Logistic regression analyses showed that age and residence in urban regions were the predictive variables that could be associated with the presence of diabetes. Alcohol consumption was not a significant predictive factor.</p

Variables Affecting Resource Subsidies from Streams and Rivers to Land and their Susceptibility to Global Change Stressors

4restrictedInternational coauthor/editorStream and river ecosystems provide subsidies of emergent adult aquatic insects and other resources to terrestrial food webs, and this lotic–land subsidy has garnered much attention in recent research. Here, we critically examine a list of biotic and abiotic variables—including productivity, dominant taxa, geomorphology, and weather—that should be important in affecting the nature of these subsidy dynamics between lotic and terrestrial ecosystems, especially the pathway from emergent aquatic insects to terrestrial predators. We also explore how interactions between these variables can lead to otherwise unexpected patterns in the importance of aquatic subsidies to terrestrial food webs. Utilizing a match-mismatch framework developed previously, we identify how these variables and interactions may be affected by a broad suite of stressors in addition to contaminants: climate change, land-use conversion, damming and water abstraction, and species invasions and extinctions. These stressors may all act to modify and potentially exacerbate the effects of contaminants on subsidies. The available literature on many variables is sparse, despite strong theoretical underpinnings supporting their importance for lotic–land subsidies. Notably, these understudied variables include those related to physical geomorphology and the structure of the stream/river and floodplain/riparian zone as well as species-specific interactions between aquatic and terrestrial organisms. We suggest that more explicit characterization of these variables and more research directly linking broad-scale stressors to subsidy resource–consumer interactions can help provide a more mechanistic understanding to lotic–land subsidy dynamics within a changing environmentrestrictedMuehlbauer, Jeffrey D.; Larsen, Stefano; Jonsson, Micael; Emilson, Erik J. S.Muehlbauer, J.D.; Larsen, S.; Jonsson, M.; Emilson, E.J.S