Four-year evaluation and association between chronic liver disease and diabetes mellitus in a patient

Öz

Background and Aims: Diabetes mellitus increases morbidity and mortality in patients with liver cirrhosis. The aim of this study was to investigate the rate of diabetes mellitus in chronic liver diseases (chronic hepatitis, liver cirrhosis and hepatocellular cancer) and to evaluate the correlation of diabetes mellituswith the etiology and severity of liver disease. Materials and Methods: One hundred and eighty-six patients withchronic liver disease (90 chronic hepatitis, 80 cirrhosis and 16 hepatocellular carcinoma) were recruited retrospectively from January 2007 to July 2010. Based on fasting blood glucose levels, normoglycemia, impaired fasting glucose, and diabetes mellitusstates among patients were determined. Patients were evaluated by classification in terms of age, gender, and etiology, and with a diagnosis of cirrhosis and hepatocellular cancer, were additionally classified in terms of Child-Pugh and MELD (Model for End-Stage Liver Disease) scores. Results: Rates of diabetes mellitusand impaired fasting glucose among chronic liver disease patients were determined as 28% and 20.4%, respectively. Normoglycemia was significantly higher in HBV patients than in HCV, alcohol-induced chronic liver disease and cryptogenic patients (p

Anahtar Kelimeler

• Liver disease, diabetes mellitus, impaired fasting glucose, Child-Pugh scores, MELD scores

4 yıllık kronik karaciğer hastalıklı olgularımızda diyabetes mellitus ile birlikteliğin değerlendirilmesi

Öz

Amaç: Kronik karaciğer hastalıklarında glikoz metabolizma bozuklukları ve diyabetes mellitus sıklığı artmıştır. Diyabet, karaciğer sirozu olan hastaların morbidite ve mortalitesini artırmaktadır. Çalışmamızın amacı, kronik karaciğer hastalığında (kronik hepatit, karaciğer sirozu ve hepatosellüler kanser) diyabetes mellitus görülme sıklığı ile karaciğer hastalığı etiyolojisi ve şiddeti arasındaki ilişkinin değerlendirilmesidir. Gereç ve Yöntem: Yüz seksen altı kronik karaciğer hastası (90 kronik hepatit, 80 siroz ve 16 hepatosellüler kanser) retrospektif olarak çalışmaya dahil edilmiştir. Hastaların açlık kan şekerleri değerlendirilerek, normoglisemi, bozulmuş açlık glikozu ve diyabetes mellitus durumları saptanmıştır. Hastalar yaş, cinsiyet, etyoloji (HBV, HCV, alkol ve kriptojenik) ve hastalık grubuna (kronik hepatit, karaciğer sirozu, hepatosellüler kanser) göre, sirozu ve hepatosellüler kanser tanısı olan olgular ise ayrıca Child-Pugh ve MELD (Model for End-Stage Liver Disease) skoruna göre gruplandırılarak değerlendirilmiştir. Sonuçlar: Kronik karaciğer hastalarında diyabet ve bozulmuş açlık glikozu sıklıkları sırasıyla %28 ve %20.4 olduğu görüldü. Sirozlu olgularda diyabetes mellitus ve bozulmuş açlık glikozu sıklığı kronik hepatitlilere göre anlamlı olarak yüksek bulundu (p=0.004). Child A, B, C ve MELD skorunun 14 ve altı ile 15 ve üstü şeklinde gruplandırılan olguların normoglisemi, bozulmuş açlık glikozu ve diyabetes mellitus dağılımlarında istatistiksel bir fark saptanmadı (p:0.781, p=0.423). Kriptojenik (%67.7), HCV (%56.8) ve alkole bağlı karaciğer hastalarında (%60), HBV'li (%38.9) olgulara göre daha yüksek oranda bozulmuş açlık glikozu ve diyabetes mellitus saptandı (p=0.017). Tartışma: Kronik karaciğer hastalarında diyabetin erken tanı ve tedavisiyle morbidite ve mortalitenin azalması beklenebilir.

Anahtar Kelimeler

• Karaciğer hastalıkları, diyabetes mellitus, bozulmuş açlık glikozu, Child-Pugh skoru, MELD skoru

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