Prevalence of diabetes mellitus in patients with end-stage liver cirrhosis due to hepatitis C, alcohol, or cholestatic disease

Nizar N. Zein, Ahmad S. Abdulkarim, Russell H. Wiesner, Kathleen S. Egan, David H. Persing

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Abstract

Background/Aims: The aims were to study: 1) the prevalence of diabetes mellitus in patients with end-stage liver cirrhosis due to hepatitis C, alcohol, or cholestatic liver disease, 2) viral and host immunogenetic factors that nay predispose to diabetes, and 3) liver transplantation outcome in patients with or without diabetes. Methods. Fasting blood glucose values of patients who underwent liver transplantation because of hepatitis C- related cirrhosis (73 patients) were compared with those of patients with cirrhosis due to cholestatic (78 patients) or alcoholic liver disease (53 patients) and to a general population. Data on diabetes prevalence in a population without liver cirrhosis was based on the prevalence of diabetes in Olmsted County, Minnesota, residents. HLA was determined using serologic assays. Hepatitis C virus genotypes were determined with polymerase chain reaction amplification and direct sequencing. Hepatitis G RNA was detected with polymerase chain reaction. Liver transplantation outcome in patients with or without diabetes was determined with rejection, retransplantation, or death at 1 year after transplantation as end points. Results: Of 64 patients with hepatitis C alone, 16 (25%) had diabetes before transplantation compared with 1 of 78 (1.3%) with cholestatic liver disease (p=0.0001) and 10 of 53 (19%) with alcoholic liver disease (p=0.36). Nine patients had hepatitis C plus cholestatic liver disease; one of these (11%) had diabetes. The prevalence of diabetes in patients with cholestatic fiver cirrhosis was not different from that of the general population. The frequency of hepatitis G virus coinfection, HLA-DR3, or HLA-DR4 in hepatitis C and diabetes was not different from that of hepatitis C alone. The distribution of hepatitis C virus genotype was similar in those with and those without diabetes. Diabetes was not associated with increased risk of rejection, retransplantation, or death at 1 year after transplantation, and had no impact on overall survival after transplantation. Conclusions: 1) The risk of diabetes is not increased in patients with liver cirrhosis due to cholestatic liver disease but is in patients with liver cirrhosis due to hepatitis C or alcoholic liver disease; 2) cofactors (age, sex, body mass index, hepatitis G virus coinfection, hepatitis C virus genotype, or HLA-DR3/DR4) did not explain the increased risk of diabetes in patients with hepatitis C; 3) diabetes before liver transplantation did not change the outcome at 1 year after transplantation or survival.

Original languageEnglish (US)
Pages (from-to)209-217
Number of pages9
JournalJournal of Hepatology
Volume32
Issue number2
StatePublished - Feb 2000

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Hepatitis C
Liver Cirrhosis
Diabetes Mellitus
Alcohols
Transplantation
Liver Transplantation
Alcoholic Liver Diseases
Liver Diseases
HLA-DR3 Antigen
Hepacivirus
GB virus C
HLA-DR4 Antigen
Fibrosis
Genotype
Coinfection
Population
Immunogenetics
Polymerase Chain Reaction
Survival
Hepatitis

Keywords

  • Alcoholic liver disease
  • Cirrhosis
  • Diabetes mellitus
  • Disease
  • Endpoints
  • Hepatitis
  • Liver
  • Outcome
  • Transplantation

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Zein, N. N., Abdulkarim, A. S., Wiesner, R. H., Egan, K. S., & Persing, D. H. (2000). Prevalence of diabetes mellitus in patients with end-stage liver cirrhosis due to hepatitis C, alcohol, or cholestatic disease. Journal of Hepatology, 32(2), 209-217.

Prevalence of diabetes mellitus in patients with end-stage liver cirrhosis due to hepatitis C, alcohol, or cholestatic disease. / Zein, Nizar N.; Abdulkarim, Ahmad S.; Wiesner, Russell H.; Egan, Kathleen S.; Persing, David H.

In: Journal of Hepatology, Vol. 32, No. 2, 02.2000, p. 209-217.

Research output: Contribution to journalArticle

Zein, NN, Abdulkarim, AS, Wiesner, RH, Egan, KS & Persing, DH 2000, 'Prevalence of diabetes mellitus in patients with end-stage liver cirrhosis due to hepatitis C, alcohol, or cholestatic disease', Journal of Hepatology, vol. 32, no. 2, pp. 209-217.
Zein, Nizar N. ; Abdulkarim, Ahmad S. ; Wiesner, Russell H. ; Egan, Kathleen S. ; Persing, David H. / Prevalence of diabetes mellitus in patients with end-stage liver cirrhosis due to hepatitis C, alcohol, or cholestatic disease. In: Journal of Hepatology. 2000 ; Vol. 32, No. 2. pp. 209-217.
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N2 - Background/Aims: The aims were to study: 1) the prevalence of diabetes mellitus in patients with end-stage liver cirrhosis due to hepatitis C, alcohol, or cholestatic liver disease, 2) viral and host immunogenetic factors that nay predispose to diabetes, and 3) liver transplantation outcome in patients with or without diabetes. Methods. Fasting blood glucose values of patients who underwent liver transplantation because of hepatitis C- related cirrhosis (73 patients) were compared with those of patients with cirrhosis due to cholestatic (78 patients) or alcoholic liver disease (53 patients) and to a general population. Data on diabetes prevalence in a population without liver cirrhosis was based on the prevalence of diabetes in Olmsted County, Minnesota, residents. HLA was determined using serologic assays. Hepatitis C virus genotypes were determined with polymerase chain reaction amplification and direct sequencing. Hepatitis G RNA was detected with polymerase chain reaction. Liver transplantation outcome in patients with or without diabetes was determined with rejection, retransplantation, or death at 1 year after transplantation as end points. Results: Of 64 patients with hepatitis C alone, 16 (25%) had diabetes before transplantation compared with 1 of 78 (1.3%) with cholestatic liver disease (p=0.0001) and 10 of 53 (19%) with alcoholic liver disease (p=0.36). Nine patients had hepatitis C plus cholestatic liver disease; one of these (11%) had diabetes. The prevalence of diabetes in patients with cholestatic fiver cirrhosis was not different from that of the general population. The frequency of hepatitis G virus coinfection, HLA-DR3, or HLA-DR4 in hepatitis C and diabetes was not different from that of hepatitis C alone. The distribution of hepatitis C virus genotype was similar in those with and those without diabetes. Diabetes was not associated with increased risk of rejection, retransplantation, or death at 1 year after transplantation, and had no impact on overall survival after transplantation. Conclusions: 1) The risk of diabetes is not increased in patients with liver cirrhosis due to cholestatic liver disease but is in patients with liver cirrhosis due to hepatitis C or alcoholic liver disease; 2) cofactors (age, sex, body mass index, hepatitis G virus coinfection, hepatitis C virus genotype, or HLA-DR3/DR4) did not explain the increased risk of diabetes in patients with hepatitis C; 3) diabetes before liver transplantation did not change the outcome at 1 year after transplantation or survival.

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KW - Alcoholic liver disease

KW - Cirrhosis

KW - Diabetes mellitus

KW - Disease

KW - Endpoints

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