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Role of Diabetes Mellitus in Liver Cirrhosis in the Anhui Region of China

DOI: 10.4236/oalib.1102101    545 Downloads   854 Views  

ABSTRACT

Aims: The aim of this study was to investigate the frequency of diabetes mellitus (DM) among cirrhotic inpatients with different etiologies and the impact of DM on the prognosis of these patients. Methods: A retrospective study of the association between DM and cirrhosis was performed on 672 cirrhotic inpatients at the First Affiliated Hospital of Anhui Medical University from January 1, 2012 to March 1, 2013. Data were assessed using SPSS 20.0. Results: The DM prevalences involving different etiologies were 45.08%, 40.43%, 42.85%, 41.67%, and 25.56% among 672 patients with alcoholic cirrhosis, cryptogenic cirrhosis, schistosomiasis, chronic hepatitis C, and chronic hepatitis B, respectively. Multivariate analysis indicated that relative to non-diabetic patients, patients with DM were older (OR 2.83, 95% CI 2.78 - 2.87, p < 0.001), had higher white blood cell levels (OR 3.01, 95% CI 2.83 - 3.22, p = 0.001) and were more frequently Child-Pugh class C (OR 1.28, 95% CI 1.14 - 1.55, p < 0.001); these differences were also statistically significant in univariate analysis. Univariate analysis suggested that the presence of DM was associated with a higher international normalized ratio (p = 0.013), a higher incidence of hepatic encephalopathy (p = 0.014), and a more frequent incidence of spontaneous bacterial peritonitis (p < 0.001). Conclusion: DM is extremely common among cirrhotic patients and is particularly prevalent among alcoholic cirrhosis patients in the examined region of China. The presence of DM in cirrhotic patients was strongly associated with an elevated Child-Pugh score and an accelerated progression of cirrhosis.

Conflicts of Interest

The authors declare no conflicts of interest.

Cite this paper

Hu, L. , Xu, X. , Zhou, Z. , Chen, G. , Ying, H. , Ye, Y. and Li, J. (2015) Role of Diabetes Mellitus in Liver Cirrhosis in the Anhui Region of China. Open Access Library Journal, 2, 1-6. doi: 10.4236/oalib.1102101.

References

[1] Barthel, A. and Schmoll, D. (2003) Novel Concepts in Insulin Regulation of Hepatic Gluconeogenesis. American Journal of Physiology-Endocrinology and Metabolism, 285, 685-692.
http://dx.doi.org/10.1152/ajpendo.00253.2003
[2] Picardi, A., D’Avola, D., Gentilucci, U.V., et al. (2006) Diabetes in Chronic Liver Disease: From Old Concepts to New Evidence. Diabetes/Metabolism Research and Reviews, 22, 274-283.
http://dx.doi.org/10.1002/dmrr.636
[3] 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
[4] Quintana, J.O., Garcia-Compean, D., Gonzdlez, J.A., Pérez, J.Z., González, F.J., et al. (201l) The Impact of Diabetes Mellitus in Mortality of Patients with Compensated Liver Cirrhosis a Prospective Study. Annals of Hepatology, 10, 56-62.
[5] 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
[6] Holstein, A., Hinze, S., Thiessen, E., Plaschke, A. and Egberts, E.H. (2002) Clinical Implications of Hepatogenous Diabetes in Liver Cirrhosis. Journal of Gastroenterology and Hepatology, 17, 677-681.
http://dx.doi.org/10.1046/j.1440-1746.2002.02755.x
[7] Wlazlo, N., Beijers, H.J., Schoon, E.J., Sauerwein, H.P. and Stehouwer, C.D. and Bravenboer, B. (2010) High Prevalence of Diabetes Mellitus in Patients with Liver Cirrhosis. Diabetic Medicine, 27, 1308-1311.
http://dx.doi.org/10.1111/j.1464-5491.2010.03093.x
[8] Huang, J.F., Yu, M.L., Dai, C.Y. and Chuang, W.L. (2013) Glucose Abnormalities in Hepatitis C Virus Infection. Kaohsiung Journal of Medical Sciences, 29, 61-68.
http://dx.doi.org/10.1016/j.kjms.2012.11.001
[9] Sporea, I., Sirli, R., Hogea, C., Sink, A.A. and Serban, V. (2009) Diabetes Mellitus and Chronic HCV Infection. Romanian Journal of Internal Medicine, 47, 141-147.
[10] Lonardo, A., Adinolfi, L.E., Petta, S., Craxì, A. and Loria, P. (2009) Hepatitis C and Diabetes: The Inevitable Coincidence? Expert Review of Anti-Infective Therapy, 7, 293-308.
http://dx.doi.org/10.1586/eri.09.3
[11] Elgouhari, H.M., Zein, C.O., Hanouneh, I., Feldstein, A.E. and Zein, N.N. (2009) Diabetes Mellitus Is Associated with Impaired Response to Antiviral Therapy in Chronic Hepatitis C Infection. Digestive Diseases and Sciences, 54, 2699-2705.
http://dx.doi.org/10.1007/s10620-008-0683-2
[12] Ferenci, P., Lockwood, A., Mullen, K., Tarter, R., Weissenborn, K. and Blei, A.T. (2002) Hepatic Encephalopathy: Definition, Nomenclature, Diagnosis, and Quantification: Final Report of the Working Party at the 11th World Congresses of Gastroenterology, Vienna, 1998. Hepatology, 35, 716-721.
http://dx.doi.org/10.1053/jhep.2002.31250
[13] Garcia-Compean, D., Jaquez-Quintana, J.O., Gonzalez-Gonzalez, 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
[14] European Association for the Study of the L (2010) EASL Clinical Practice Guidelines on the Management of Ascites, Spontaneous Bacterial Peritonitis, and Hepatorenal Syndrome in Cirrhosis. Journal of Hepatology, 53, 397-417.
http://dx.doi.org/10.1016/j.jhep.2010.05.004
[15] Nielsen, M.F., Caumo, A., Aagaard, N.K., Chandramouli, V., Schumann, W.C., Landau, B.R., et al. (2005) Contribution of Defects in Glucose Uptake to Carbohydrate Intolerance in Liver Cirrhosis: Assessment during Physiological Glucose and Insulin Concentrations. American Journal of Physiology—Gastrointestinal and Liver Physiology, 288, 1135-1143.
http://dx.doi.org/10.1152/ajpgi.00278.2004
[16] Perry, R.J., Camporez, J.P.G., Kursawe, R., et al. (2015) Hepatic Acetyl CoA Links Adipose Tissue Inflammation to Hepatic Insulin Resistance and Type 2 Diabetes. Cell, 160, 1-14.
http://dx.doi.org/10.1016/j.cell.2015.01.012
[17] Papatheodoridis, G.V., Chrysanthos, N., Savvas, S., et al. (2006) Diabetes Mellitus in Chronic Hepatitis B and C: Prevalence and Potential Association with the Extent of Liver Fibrosis. Journal of Viral Hepatitis, 13, 303-310.
http://dx.doi.org/10.1111/j.1365-2893.2005.00677.x
[18] Ampuero, J., Ranchal, I., Del Mar Díaz-Herrero, M., Del Campo, J.A., Bautista, J.D. and Romero-Gómez, M. (2013) Role of Diabetes Mellitus on Hepatic Encephalopathy. Metabolic Brain Disease, 28, 277-279.
http://dx.doi.org/10.1007/s11011-012-9354-2
[19] Butt, Z., Jadoon, N.A., Salaria, O.N., Mushtaq, K., Riaz, I.B., Shahzad, A., et al. (2013) Diabetes Mellitus and Decompensated Cirrhosis: Risk of Hepatic Encephalopathy in Different Age Groups. Journal of Diabetes, 5, 449-455.
http://dx.doi.org/10.1111/1753-0407.12067
[20] Poh, Z. and Chang, P.E. (2012) A Current Review of the Diagnostic and Treatment Strategies of Hepatic Encephalopathy. International Journal of Hepatology, 2012, Article ID: 480309.
http://dx.doi.org/10.1155/2012/480309
[21] 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
[22] Diaz, J., Monge, E., Roman, R. and Ulloa, V. (2008) Diabetes as a Risk Factor for Infections in Cirrhosis. American Journal of Gastroenterology, 103, 248.
http://dx.doi.org/10.1111/j.1572-0241.2007.01562_9.x
[23] Sigal, S.H., Stanca, C.M., Kontorinis, N., Bodian, C. and Ryan, E. (2006) Diabetes Mellitus Is Associated with Hepatic Encephalopathy in Patients with HCV Cirrhosis. American Journal of Gastroenterology, 101, 1490-1496.
http://dx.doi.org/10.1111/j.1572-0241.2006.00649.x

  
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