Prevalence and determinants of diabetes mellitus among Iranian patients with chronic liver disease

被引：17

作者：

Alavian S.M. ^{[1
,2
]}

Hajarizadeh B. ^{[2
]}

Nematizadeh F. ^{[1
,2
]}

Larijini B. ^{[3
]}

机构：

[1] Department of Internal Medicine, Baghiatollah Univ. of Medical Sci., Tehran

[2] Tehran Hepatitis Center, Tehran

[3] Endocrinol./Metabolism Res. Center, Tehran University of Medical Sci., Tehran

来源：

BMC Endocrine Disorders | / 4卷 / 1期

关键词：

Chronic Hepatitis; Chronic Liver Disease; Impaired Glucose Tolerance; Cirrhotic Patient; Impaired Fasting Glucose;

D O I：

10.1186/1472-6823-4-4

中图分类号：

学科分类号：

摘要：

Background. Alterations in carbohydrate metabolism are frequently observed in cirrhosis. We conducted this study to define the prevalence of diabetes mellitus (DM) and impaired glucose tolerance (IGT) in Iranian patients with chronic liver disease (CLD), and explore the factors associated with DM in these patients. Methods. One hundred and eighty-five patients with CLD were enrolled into the study. Fasting plasma glucose and two-hour plasma glucose were measured in patients' sera. DM and IGT were diagnosed according to the latest American Diabetes Association criteria. Results. The subjects included 42 inactive HBV carriers with a mean age of 42.2±12.0 years, 102 patients with HBV or HCV chronic hepatitis with a mean age of 41.2±10.9 years, and 41 cirrhotic patients with a mean age of 52.1±11.4 years. DM and IGT were diagnosed in 40 (21.6%) and 21 (11.4%) patients, respectively. Univariate analysis showed that age (P=0.000), CLD status (P=0.000), history of hypertension (P=0.007), family history of DM (P=0.000), and body mass index (BMI) (P=0.009) were associated with DM. Using Multivariate analysis, age (OR=4.7, 95%CI: 1.8-12.2), family history of DM (OR=6.6, 95%CI: 2.6-17.6), chronic hepatitis (OR=11.6, 95%CI: 2.9-45.4), and cirrhosis (OR=6.5, 95%CI: 2.4-17.4) remained as the factors independently associated with DM. When patients with cirrhosis and chronic hepatitis were analyzed separately, higher Child-Pugh's score in cirrhotic patients (OR=9.6, 95%CI: 1.0-88.4) and older age (OR=7.2, 95%CI: 1.0-49.1), higher fibrosis score (OR=59.5, 95%CI: 2.9-1211.3/ OR=11.9, 95%CI: 1.0-132.2), and higher BMI (OR=30.3, 95%CI: 3.0-306.7) in patients with chronic hepatitis were found to be associated with higher prevalence of DM. Conclusions. Our findings indicate that patients with cirrhosis and chronic hepatitis are at the increased risk of DM occurrence. Older age, severe liver disease, and obesity were associated with DM in these patients. © 2004 Alavian et al., licensee BioMed Central Ltd.

引用

页数：7

共 28 条

[1] Megyesi C., Samols E., Marks V., Glucose tolerance and diabetes in chronic liver disease, Lancet, 2, pp. 1051-1056, (1967)
[2] Petrides A.S., DePronzo R.A., Glucose metabolism in cirrhosis: A review with some perspectives for the future, Diabetes Metab. Rev., 5, pp. 691-709, (1989)
[3] Muting D., Wohlgemuth D., Dorsett R., Liver cirrhosis and diabetes mellitus, Geriatrics, 24, pp. 91-99, (1969)
[4] Kingston M.E., Aschraf M.A., Atiyeh M., Donnoley R.J., Diabetes mellitus in chronic active hepatitis and cirrhosis, Gastroenterology, 87, pp. 688-694, (1984)
[5] Buzzelli G., Chiarantini E., Cotrozzi G., Relli P., Matassi L., Romanelli R.G., Gentilini P., Estimate of prevalence of glucose intolerance in chronic liver disease. Degree of agreement among some diagnostic criteria, Liver, 8, 6, pp. 354-359, (1988)
[6] Vidal J., Ferre J.P., Esmatjes E., Salmeron J.M., Gonzalez-Clemente J.M., Gomis R., Rodes J., Diabetes mellitus in patients with liver cirrhosis, Diabetes Res. Clin. Pract., 25, pp. 19-25, (1994)
[7] Muller M.J., Pirlich M., Balks H.J., Selberg O., Glucose intolerance in liver cirrhosis: Role of hepatic and non-hepatic influences, Eur. J. Clin. Chem. Clin. Biochem., 32, 10, pp. 749-758, (1994)
[8] Bianchi G., Marchesini G., Zoli M., Bugianeci E., Fabbri A., Pisi E., Prognostic significance of diabetes in patients with cirrhosis, Hepatology, 20, 1, pp. 119-125, (1994)
[9] Muller M.J., Are patients with cirrhosis glucose resistant?, J. Hepatol., 22, pp. 504-507, (1995)
[10] Zein N.N., Abdulkarim A.S., Wiesner R.H., Egan K.S., Persing D.H., Prevalence of diabetes mellitus in patients with end-stage liver cirrhosis due to hepatitis C, alcohol, or cholestatic disease, J. Hepatol., 32, pp. 209-217, (2000)

← 1 2 3 →