Endocrine manifestations of hepatitis C virus infection

被引:87
作者
Antonelli, Alessandro [1 ]
Ferri, Clodoveo [2 ]
Ferrari, Silvia Martina
Colaci, Michele [2 ]
Sansonno, Domenico [3 ]
Fallahi, Poupak
机构
[1] Univ Pisa, Sch Med, Dept Internal Med, I-56100 Pisa, Italy
[2] Univ Modena, Dept Internal Med, I-41100 Modena, Italy
[3] Univ Bari, Dept Internal Med & Clin Oncol, I-70121 Bari, Italy
来源
NATURE CLINICAL PRACTICE ENDOCRINOLOGY & METABOLISM | 2009年 / 5卷 / 01期
关键词
diabetes mellitus; hepatitis C virus; mixed cryoglobulinemia; thyroid autoimmunity; thyroid cancer; ALPHA-CHEMOKINE CXCL10; INDUCIBLE PROTEIN-10 LEVELS; CCL2; SERUM-LEVELS; THYROID-CANCER; MIXED CRYOGLOBULINEMIA; CORE PROTEIN; IFN-GAMMA; GLUCOSE-TOLERANCE; INTERFERON-ALPHA; HCV;
D O I
10.1038/ncpendmet1027
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Chronic infection with hepatitis C virus (HCV) can result in both hepatic and extrahepatic disease and endocrine dysfunction represents an important class of HCV-related extrahepatic disease. The most frequently occurring-and clinically important-of these endocrine disorders are thyroid disease and type 2 diabetes mellitus. In this Review, we evaluate the evidence in support of a link between HCV infection and endocrine-system dysfunction, and discuss potential pathophysiological mechanisms. A meta-analysis of the literature has revealed significant associations between chronic HCV infection, thyroid autoimmunity and hypothyroidism. Furthermore, a high prevalence of thyroid cancer has been reported in HCV-positive patients. Several clinicoepidemiological studies have demonstrated that chronic HCV infection could lead to the development of type 2 diabetes mellitus, possibly as a result of HCV-induced metabolic disturbances. Some researchers have postulated that a type 1 T-helper -cell mediated immune response underpins the association of chronic HCV infection with endocrine disease. Indeed, the available data suggest that a common immunological, type 1 T-helper cell pattern of cytokine expression and activation (via interferon-gamma) could provide the pathophysiological basis for this association. Nonetheless, additional studies will be necessary to elucidate fully all the mechanisms involved in HCV-related endocrine dysfunction.
引用
收藏
页码:26 / 34
页数:9
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