Document Detail

Hepatogenous Diabetes in Cirrhosis Is Related to Portal Pressure and Variceal Hemorrhage.
MedLine Citation:
PMID:  23912248     Owner:  NLM     Status:  Publisher    
BACKGROUND AND AIM: The clinical impact and complications of hepatogenous diabetes (HD) on cirrhosis have not been elucidated. This study aimed to evaluate the relationship of HD with portal hypertension (PHT) and variceal hemorrhage and to assess the prevalence of HD.
METHODS: From July 2007 to December 2009, 75-g oral glucose tolerance test and insulin resistance (IR) were evaluated for 195 consecutive cirrhotic liver patients (M:F = 164:1, 53.0 ± 10.2 years) who had no history of diabetes mellitus. IR was calculated using the homeostasis model of assessment-insulin resistance (HOMA-IR) formula. Endoscopy for varices, hepatic venous pressure gradient (HVPG), and serologic tests were also conducted.
RESULTS: HD was observed in 55.4 % (108/194) of the patients. Among them, 62.0 % required OGTT for diagnosis because they did not show an abnormal fasting plasma glucose level. The presence of HD showed a significant correlation with high Child-Pugh's score, variceal hemorrhage, and HVPG (p = 0.004, 0.002, and 0.019, respectively). In multivariate analysis, Child-Pugh's score (OR 1.43, 95 % CI 1.005-2.038) and HVPG (OR 1.15, 95 % CI 1.003-2.547) had significant relationships with HD. Patients with recent variceal hemorrhages (within 6 months) exhibited significantly higher glucose levels at 120 min in OGTT compared to patients without hemorrhages (p = 0.042). However, there was no difference in fasting glucose levels. The 120-min glucose level and HOMA-IR score were significantly and linearly correlated with HVPG (r (2) = 0.189, p < 0.001 and r (2) = 0.033, p = 0.011, respectively).
CONCLUSION: HD and IR have significant relationships with PHT and variceal hemorrhage. Postprandial hyperglycemia in particular had a significant relationship with variceal hemorrhage.
Hyo Keun Jeon; Moon Young Kim; Soon Koo Baik; Hong Jun Park; Hoon Choi; So Yeon Park; Bo Ra Kim; Jin Heon Hong; Ki Won Jo; Seung Yong Shin; Jung Min Kim; Jae Woo Kim; Hyun Soo Kim; Sang Ok Kwon; Young Ju Kim; Seung Hwan Cha; Dong Joon Kim; Ki Tae Suk; Gab Jin Cheon; Young Don Kim; Dae Hee Choi; Sung Joon Lee
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-8-4
Journal Detail:
Title:  Digestive diseases and sciences     Volume:  -     ISSN:  1573-2568     ISO Abbreviation:  Dig. Dis. Sci.     Publication Date:  2013 Aug 
Date Detail:
Created Date:  2013-8-5     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7902782     Medline TA:  Dig Dis Sci     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Department of Internal Medicine, Wonju College of Medicine, Wonju Christian Hospital, Yonsei University, 162, Ilsan-dong, Wonju, Republic of Korea.
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