2型糖尿病患者戊型肝炎病毒感染状况调查

目的 调查2型糖尿病患者戊型肝炎病毒（hepatitis E virus， HEV）感染状况，并分析糖尿病合并肝功能异常与HEV感染的关系。方法 纳入住院治疗的2型糖尿病患者413例，其中病程小于6个月的新确诊病例78例。采用ELISA法初筛血清抗-HEV IgG和IgM抗体，阳性血清进一步采用Western blot法确认。结果 男性230例，女性183例，平均年龄58.3 ± 14.8岁（14~90岁）。抗-HEV IgG阳性145例（35.1％），男性与女性阳性率分别为35.2%和35.0%（P=0.959）；抗-HEV IgG阳性率随年龄而升高，至40岁后稳定在35%左右。新确诊与非新确诊糖尿病患者抗-HEV IgG阳性率基本相同（35.9%和34.9%，P=0.871）。各项肝功能指标异常者与正常者的抗-HEV IgG阳性率相似，抗-HEV IgG阳性和阴性两组患者的肝功能异常率基本相同。此外，3例（0.7%）患者抗-HEV IgG和IgM同时阳性，均为非新确诊病例，肝功能正常。结论 本组2型糖尿病患者抗-HEV IgG血清流行率为35.1%，近期感染率0.7%，为亚临床感染。本研究结果提示，糖尿病发病与HEV感染无关，抗-HEV IgG阳性对糖尿病患者的肝功能无不良影响。

Seroprevalence and Incidence of Hepatitis E Virus Infection in Patients with Type 2 Diabetes Mellitus

Objective To investigate the status of hepatitis E virus (HEV) infection in patients with type 2 diabetes mellitus and assess the role of HEV infection in the patients with abnormal liver function tests. Methods Serum samples from 413 hospitalized patients with type 2 diabetes mellitus, including 78 newly diagnosed ones, were tested for anti-HEV IgG and IgM by a unique ELISA based on the immunodominant polypeptide and truncated polypeptide. The positive samples were further confirmed by Western blotting. Statistical analysis was done with chi-square test or Fisher''s exact test. Results Of the 413 patients, 230 were male and 183 were female, with the average age 58.3 ± 14.8 years old (14-90). Totally 145 (35.1%) patients were anti-HEV IgG positive. The prevalence had no statistical difference between male and female patients (35.2% vs 35.0%, P=0.959). The prevalence was increased over the age and reached to relative constancy (35%) after 40 years old. The prevalence of anti-HEV IgG in the newly diagnosed patients was comparable with that in the non-newly diagnosed ones (35.9% vs 34.9%, P=0.871). The patients with abnormal liver function tests showed similar positive rate of anti-HEV IgG compared with those with normal liver function tests. The patients with positive anti-HEV IgG and negative anti-HEV IgG had similar rates of abnormal liver function tests. Additionally, three non-newly diagnosed patients were positive for both IgM and IgG, with normal liver functions. Conclusion The prevalence of anti-HEV IgG in this group of type 2 diabetes patients was 35.1% and the incidence rate of subclinical infection was 0.7%. The data suggest that the onset of type 2 diabetes is less likely associated with HEV infection, which has minimal long-term influence on the liver functions in the patients with type 2 diabetes patients.