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Glucose Metabolism Disorders in Cirrhosis: Frequency and Risk Factors in Tunisian Population. Results of a Cross-Sectional Study

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DOI: 10.4236/ojgas.2014.48042    2,587 Downloads   3,025 Views   Citations

ABSTRACT

Background and aims: Alterations in carbohydrate metabolism are frequently observed in cirrhosis; to determine the frequency of diabetes mellitus and impaired glucose tolerance in Tunisian cirrhotic patients and identify risk factors. Patients and methods: Cross-sectional study; fasting plasma glucose levels were measured in consecutive patients with cirrhosis. Oral glucose tolerance test was performed if fasting plasma glucose level was normal. Glucose metabolism disorders were then classified as: impaired glucose tolerance and diabetes mellitus. Cirrhotics with glucose metabolism disorder were compared to those without. Results: Seventy-seven patients with cirrhosis were included: 68.8% were diagnosed as having glucose metabolism disorder; diabetes in 42.8% and impaired glucose tolerance in 26%. The tests were able to identify 60.4% of glucose metabolism disorders. Univariate analysis disclosed a higher proportion of female gender (p = 0.04) and more frequent familial history of diabetes mellitus (p = 0.005) in the group with glucose metabolism disorder. There were no statistically differences regarding age, etiology and severity of the cirrhosis, and dry body mass index. Multivariate analysis showed that familial history of diabetes was the only independent risk factor (OR = 5.1, p = 0.005). Conclusion: In our study, the frequency of glucose metabolism disorders was 68.8%. Oral glucose tolerance test allowed disclosing nearly half of them, pointing a high incidence of latent glucose metabolism disorders. In this way, it should be routinely evaluated in all patients with cirrhosis. Familial history of diabetes was the only independent risk factor, suggesting that other factors in addition to liver disease may play a role.

Conflicts of Interest

The authors declare no conflicts of interest.

Cite this paper

Ennaifer, R. , Cheikh, M. , Hefaiedh, R. , Romdhane, H. , Nejma, H. and Hadj, N. (2014) Glucose Metabolism Disorders in Cirrhosis: Frequency and Risk Factors in Tunisian Population. Results of a Cross-Sectional Study. Open Journal of Gastroenterology, 4, 289-294. doi: 10.4236/ojgas.2014.48042.

References

[1] Buyse, S. and Valla, D. (2007) Carbohydrate Metabolism Dysregulation in Cirrhosis: Pathophysiology, Prognostic Impact and Therapeutic Implications. Gastroentérologie Clinique et Biologique, 31, 266-273.
http://dx.doi.org/10.1016/S0399-8320(07)89371-7
[2] Garcia-Compean, D., Jaquez-Quintana, J.O., Gonzales-Gonzales, J.A. and Maldonado-Garza, H. (2009) Liver Cirrhosis and Diabetes: Risk Factors, Pathophysiology, Clinical Implications and Management. World Journal of Gastroenterology, 15, 280-288.
http://dx.doi.org/10.3748/wjg.15.280
[3] Alavian, S.M., Hajarizadeh, B., Nematizadeh, F. and Larijani, B. (2004) Prevalence and Determinants of Diabetes Mellitus among Patients with Chronic Liver Disease. BMC Endocrine Disorders, 4, 4.
http://dx.doi.org/10.1186/1472-6823-4-4
[4] Wlazlo, N., Van Greevenbroek, M.M., Curvers, J., Schoon, E.J., Friederich, P., Twisk, J.W., et al. (2013) Diabetes Mellitus at the Time of Diagnosis of Cirrhosis Is Associated with Higher Incidence of Spontaneous Bacterial Peritonitis, but Not with Increased Mortality. Clinical Science, 125, 341-348.
http://dx.doi.org/10.1042/CS20120596
[5] Jaquez Quintana, J.O., Garcia-Compean, D., Gonzales Gonzales, J.A., Villarreal Perez, J.Z., Lavalle Gonzales, F.J., Munoz Espinosa, L.E., et al. (2011) The Impact of Diabetes Mellitus in Mortality of Patients with Compensated Liver Cirrhosis—A Prospective Study. Annals of Hepatology, 10, 56-62.
[6] Braganca, A.C. and Alvares-da-Silva, M.R. (2010) Prevalence of Diabetes Mellitus and Impaired Glucose Tolerance in Patients with Decompensated Cirrhosis Being Evaluated for Liver Transplantation: The Utility of Oral Glucose Tolerance Test. Archives of Gastroenterology, 47, 22-27.
[7] American Diabetes Association (2011) Diagnosis and Classification of Diabetes Mellitus. Diabetes Care, 34, S62-S69.
http://dx.doi.org/10.2337/dc11-S062
[8] Garcia-Compean, D., Jaquez-Quintana, J.O., Lavalle-Gonzales, F.J., Reyes-Cabello, E., Gonzales-Gonzales, J.A., Munoz-Espinosa, L.E., et al. (2012) The Prevalence and Clinical Characteristics of Glucose Metabolism Disorders in Patients with Liver Cirrhosis. A Prospective Study. Annals of Hepatology, 11, 240-248.
[9] Bouguerra, R., Alberti, H., Salem, L.B., Rayana, C.B., Atti, J.E., Gaigi, S., et al. (2007) The Global Diabetes Pandemic: The Tunisian Experience. European Journal of Clinical Nutrition, 61, 160-165.
http://dx.doi.org/10.1038/sj.ejcn.1602478
[10] Gentile, S., Loguercio, C., Marmo, R., Carbone, L. and Del Vecchio Blanco, C. (1993) Incidence of Altered Glucose Tolerance in Liver Cirrhosis. Diabetes Research and Clinical Practice, 2, 37-44.
http://dx.doi.org/10.1016/0168-8227(93)90130-W
[11] Hickman, I.J. and Macdonald, G.A. (2007) Impact of Diabetes on the Severity of Liver Disease. The American Journal of Medicine, 120, 829-834.
http://dx.doi.org/10.1016/j.amjmed.2007.03.025
[12] Zein, N.N., Abdulkarim, A.S., Wiesner, R.H., Egan, K.S. and Persing, D.H. (2000) Prevalence of Diabetes Mellitus in Patients with End-Stage Liver Cirrhosis Due to Hepatitis C, Alcohol, or Cholestatic Disease. Journal of Hepatology, 32, 209-217.
http://dx.doi.org/10.1016/S0168-8278(00)80065-3
[13] Vidal, J., Ferrer, J.P., Esmatjes, E., Salmeron, J.M., Gonzales-Clemente, J.M., Gomis, R., et al. (1994) Diabetes Mellitus in Patients with Liver Cirrhosis. Diabetes Research and Clinical Practice, 25, 19-25.
http://dx.doi.org/10.1016/0168-8227(94)90157-0
[14] Moscatiello, S., Manini, R. and Marchesini, G. (2007) Diabetes and Liver Disease: An Ominous Association. Nutrition, Metabolism and Cardiovascular Diseases, 17, 63-70.
http://dx.doi.org/10.1016/j.numecd.2006.08.004

  
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