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ISSN 1001-5256 (Print)
ISSN 2097-3497 (Online)
CN 22-1108/R
Issue 2
Feb.  2016
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Article Contents

Clinical features of male patients with alcoholic liver cirrhosis or hepatitis B cirrhosis complicated by abnormal glucose metabolism

DOI: 10.3969/j.issn.1001-5256.2016.02.020
  • Received Date: 2015-04-07
  • Published Date: 2016-02-20
  • Objective To investigate the clinical features of male patients with alcoholic liver cirrhosis( ALC) or hepatitis B cirrhosis( HBC) complicated by abnormal glucose metabolism. Methods A total of 287 patients with liver cirrhosis who were admitted to Guangzhou Panyu Central Hospital from January 2008 to September 2013 were selected. Among these patients,74 had ALC and were all male,including 54 with abnormal glucose metabolism; the other 213 had HBC,including 97 with abnormal glucose metabolism( 69 male patients and28 female patients). A controlled study was performed for the clinical data of ALC and HBC patients with abnormal glucose metabolism,to investigate the association of patients' clinical manifestations with the indices for laboratory examination,insulin resistance index,incidence rate of abnormal glucose metabolism,and Child- Pugh class. The t- test was applied for comparison of continuous data between groups,the chi- square test was applied for comparison of categorical data between groups,and the Spearman rank correlation was applied for correlation analysis. Results Compared with HBC patients,ALC patients had significantly higher incidence rates of abnormal glucose metabolism( 73. 0% vs 32. 4%),hepatogenous diabetes( 35. 1% vs 14. 6%),fasting hypoglycemia( 27. 0% vs 10. 3%),and impaired glucose tolerance( 31. 1% vs 14. 1%)( χ2= 4. 371,3. 274,4. 784,and 1. 633,all P < 0. 05). The Spearman correlation analysis showed that in ALC and HBC patients,the incidence rate of abnormal glucose metabolism was positively correlated with Child- Pugh class( rs= 0. 41,P <0. 05). Compared with the HBC patients with abnormal glucose metabolism,the ALC patients with abnormal glucose metabolism had a significantly higher incidence rate of Child- Pugh class A( χ2= 7. 520,P = 0. 001),and a significantly lower incidence rate of Child- Pugh class C( χ2= 6. 542,P = 0. 003). There were significant differences in the incidence rates of dim complexion,telangiectasia of the face,spider angioma,hepatomegaly,hepatorenal syndrome,malnutrition,ascites,jaundice,hepatic encephalopathy,spontaneous bacterial peritonitis,and upper gastrointestinal bleeding between the ALC and HBC patients with abnormal glucose metabolism( χ2= 3. 785,2. 651,1. 974,3. 316,3. 771,5. 843,7. 251,5. 214,5. 778,2. 966,and 6. 312,all P < 0. 05). Compared with the HBC patients with abnormal glucose metabolism,the ALC patients with abnormal glucose metabolism had significantly higher levels of aspartate aminotransferase and total bilirubin,a significantly greater mean corpuscular volume,a significantly higher level of gamma- glutamyl transpeptidase,and a significantly lower level of albumin( t = 4. 775,7. 887,5. 143,6. 124,and 5. 210,all P < 0. 05). There were significant differences in the fasting blood glucose level,insulin level 2 hours after meal,and insulin resistance index between the ALC and HBC patients with abnormal glucose metabolism( t = 2. 770,6. 331,and 3. 770,all P < 0. 05). Conclusion The male patients with ALC or HBC gradually develop abnormal glucose metabolism with the deterioration of liver function,with individual etiology and features of liver cirrhosis,and the manifestations of abnormal glucose metabolism are not obvious. Related examinations should be performed for these male patients with liver cirrhosis of various causes,to confirm the existence of abnormal glucose metabolism.

     

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  • [1]GARCIA-COMPEAN D,JAQUEZ-QUINTANA JO,MALDONADO-GARZA H.Hepatogenous diabetes.Current views of an ancient problem[J].Ann Hepatol,2009,8(1):13-20.
    [2]Chinese Society of Hepatology and Chinese Society of Infectious Diseases,Chinese Medical Association.The guideline of prevention and treatment for chronic hepatitis B(2010 version)[J].J Clin Hepatol,2011,27(1):I-XVI.(in Chinese)中华医学会肝病学分会,中华医学会感染病学分会.慢性乙型肝炎防治指南(2010年版)[J].临床肝胆病杂志,2011,27(1):I-XVI.
    [3] Fatty Liver and Alcoholic Liver Disease Study Group of the Chinese Liver Disease Association,Chinese Medical Association.Guidelines for prevention and treatment of alcoholic liver disease(revised version 2010)[J].J Clin Hepatol,2010,26(3):229-232.(in Chinese)中华医学会肝病学分会脂肪肝和酒精性肝病学组.酒精性肝病诊疗指南(2010年修订版)[J].临床肝胆病杂志,2010,26(3):229-232.
    [4]American Diabetes Association.Clinical practice recommendations2001:gestational diabetes mellitus[J].Diabetes Care,2001,24(9):s77-s79.
    [5]SIBLEY D,PALMLMER JP,HIRSCH IB,et al.Visceral obesity,hepatic lipase activity and dyslipidemia in type 1 diabetes[J].J Clin Endocrinol Metab,2003,88(7):3379-3384.
    [6]GARCIA-COMPEAN D,GONZALEZ-GONZALEZ JA,LAVALLE-GONZALEZ FJ,et al.Current concepts in diabetes mellitus and chronic liver disease:clinical outcomes,hepatitis C virus association,and therapy[J].Dig Dis Sci,2015.[Epub ahead of print]
    [7]GARCIA-COMPEAN D,JAQUEZ-QUINTANA JO,LAVALLEGONZALEZ FJ,et al.Subclinical abnormal glucose tolerance is a predictor of death in liver cirrhosis[J].World J Gastroenterol,2014,20(22):7011-7018.
    [8]BIANEHI G,MATCHESINI G,ZOLI M,et al.Prognostic significance of diabetes in patients with cirrhosis[J].Hepatology,1994,20(1):119-125.
    [9]WLAZLO N,van GREEVENBROEK MM,CURVERS J,et al.Diabetes mellitus at the time of diagnosis of cirrhosis is associated with higher incidence of spontaneous bacterial peritonitis,but not with increased mortality[J].Clin Sci(Lond),2013,125(7):341-348.
    [10]YANG CH,CHIU YC,CHEN CH,et al.Diabetes mellitus is associated with gastroesophageal variceal bleeding in cirrhotic patients[J].Kaohsiung J Med Sci,2014,30(10):515-520.
    [11]BUTT Z,JADOON NA,SALARIA ON,et al.Diabetes mellitus and decompensated cirrhosis:risk of hepatic encephalopathy in different age groups[J].J Diabetes,2013,5(4):449-455.
    [12]LING Q,DONG F,GENG L,et al.Impacts of TCF7L2 gene polymorphisms on the susceptibility of hepatogenous diabetes and hepatocellular carcinoma in cirrhotic patients[J].Gene,2013,522(2):214-218.
    [13]JEON HK,KIM MY,BAIK SK,et al.Hepatogenous diabetes in cirrhosis is related to portal pressure and variceal hemorrhage[J].Dig Dis Sci,2013,58(11):3335-3341.
    [14]LI JN,LAI YM,QIAN JM,et al.Trends in etiologies of chronic pancreatitis within 20 years:analysis of 636 cases[J].Chin Med J(Engl),2011,124(21):3556-3559.
    [15]ZHANG XJ.Clinical analysis of the incidence of low blood sugar in patients with intensive insulin therapy[J].Modern Prevent Med,2011,38(12):2445-2446,2450.(in Chinese)张旭娟.肝源性糖尿病患者胰岛素强化治疗后低血糖发生率的临床分析[J].现代预防医学,2011,38(12):2445-2446,2450.
    [16]BAO ZY,YUAN XD,DUAN SH.Analysis of risk factor of cirrhosis complicated by hepatogeous diabetes[J].Modern Prevent Med,2011,38(19):3885-3887.(in Chinese)鲍中英,苑晓东,段淑红.肝硬化发生肝源性糖尿病的相关因素分析[J].现代预防医学,2011,38(19):3885-3887.
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