Prevalence and predictive factors of diabetes in hepatitis virus positive liver cirrhosis with fasting plasma glucose level of <126 mg/dL

Naoki Matsumoto; Yasuji Arase; Yuya Seko; Norihiro Imai; Yusuke Kawamura; Hitomi Sezaki; Tetsuya Hosaka; Norio Akuta; Mariko Kobayashi; Masahiro Kobayashi; Yoshiyuki Suzuki; Satoshi Saito; Fumitaka Suzuki; Kenji Ikeda; Hiromitsu Kumada; Kaoru Aida; Tetsuro Kobayashi

doi:10.1111/j.1872-034X.2011.00957.x

Prevalence and predictive factors of diabetes in hepatitis virus positive liver cirrhosis with fasting plasma glucose level of <126 mg/dL

Hepatol Res. 2012 Jun;42(6):558-63. doi: 10.1111/j.1872-034X.2011.00957.x. Epub 2012 Jan 11.

Authors

Naoki Matsumoto¹, Yasuji Arase, Yuya Seko, Norihiro Imai, Yusuke Kawamura, Hitomi Sezaki, Tetsuya Hosaka, Norio Akuta, Mariko Kobayashi, Masahiro Kobayashi, Yoshiyuki Suzuki, Satoshi Saito, Fumitaka Suzuki, Kenji Ikeda, Hiromitsu Kumada, Kaoru Aida, Tetsuro Kobayashi

Affiliation

¹ Department of Hepatology and Okinaka Memorial Institute for Medical Research Department of Health Management Center, Toranomon Hospital, Tokyo Department of Third Internal Medicine (Metabolism), University of Yamanashi, Yamanashi, Japan.

PMID: 22236146
DOI: 10.1111/j.1872-034X.2011.00957.x

Abstract

Aim: The aim of this study was to evaluate the prevalence and predictive factors of diabetes in hepatitis virus positive liver cirrhotic patients with fasting plasma glucose (FPG) level of <126 mg/dL.

Methods: A total of 263 patients with hepatitis C virus (HCV) or hepatitis B virus (HBV) positive liver cirrhosis, FPG level of <126 mg/dL, and had diabetes status evaluated by the use of 75-g oral glucose tolerance test (OGTT), were enrolled in this study. Plasma glucose and insulin levels were analyzed periodically for 3 h after oral glucose loading. Diabetes was defined as a 2-h post-load glucose on the OGTT of ≥200 mg/dL. The prevalence of diabetes by use of OGTT and predictive factors for diabetes were evaluated by the use of the Mann-Whitney U-test, Fisher's exact probability test or multivariate analysis by logistic regression. Hypoalbuminemia was defined as serum albumin level of <3.9 g/dL. Elevated indocyanine green retention rate at 15 min (ICG( R) 15) was regarded as ≥ 25%.

Results: Out of 263 patients, 44 (16.7%) were diagnosed as having diabetes. Multivariate analysis showed that diabetes occurred when patients had hypoalbuminemia of <3.9 g/dL (odds ratio [OR] 2.33; 95% confidential interval [CI] = 1.04-5.24; P = 0.040) and ICG( R) 15 of <25% (OR 2.36; 95%CI = 1.01-5.58).

Conclusions: Hypoalbuminemia and elevated ICG( R) 15 in hepatitis virus related cirrhotic patients with FPG level of <126 mg/day enhance diabetes pattern after OGTT with significant difference.