Diabetes and Herpes Zoster Association: A systematic Review and Meta-analysis

Background: Diabetes mellitus is known to be a potential risk factor for herpes zoster (HZ). The aim of the present study was to investigate the relationship between diabetes and HZ statistically. What is the status of diabetes in people with HZ, and are diabetes and HZ associations statistically significant? Answering these questions is the main purpose of this study. Methods: Systematic search was carried out in four major international databases, including PubMed, Scopus, Web of Science, and Google scholar for eligible records between January 2000 and December 2020. The overall prevalence of diabetes in HZ people, studies heterogeneity, as well as geographical distribution were estimated by a random-effect model applied in comprehensive meta-analysis (V2, BioStat) software. Results: Ultimately, 28 studies (29 datasets) were included in the present meta-analysis. The overall prevalence of diabetes in HZ people was estimated to be 12.7% (95% CI: 11.5%- 14%), the highest and lowest prevalence rates were 17.4% and 4% in Southeast Asian and American regions, respectively. Additionally, the odds ratio (OR) results suggested a significant association between HZ and diabetes (OR: 1.28, 95% CI: 1.18-1.38). Conclusion: The results indicate a significant association between HZ and diabetes, and this association should not be neglected. Future studies may reflect the effect of vaccination more seriously by considering this association.