Prime Pubmed | Hepatogenous Journal Articles From Pubmed
IJIndian J Endocrinol Metab 2018 Jul-Aug; 22(4):552-559 The prevalence of diabetes mellitus in cirrhotic patients is much higher than that in the general population. Two types of diabetes are usually seen in patients with cirrhosis: type 2 diabetes mellit... The prevalence of diabetes mellitus in cirrhotic patients is much higher than that in the general population. Two types of diabetes are usually seen in patients with cirrhosis: type 2 diabetes mellitus and hepatogenous diabetes (HD). The HD is an acquired condition which is believed to be caused by impaired insulin clearance and pancreatic -cell dysfunction in cirrhotic patients. Increased levels of advanced glycation end products and hypoxia-inducible factors have been implicated in the pathogenesis of HD. Patients with HD typically present with normal fasting glucose, but abnormal response to an oral glucose tolerance test, which is required for the diagnosis. Because the level of glycated hemoglobin is often falsely low in patients with cirrhosis, it does not help in the early diagnosis of HD. HD is associated with an increased rate of complications of cirrhosis, decreased 5-year survival rate, and increased risk of hepatocellular carcinoma. The major complications of cirrhosis associated with HD include hepatic encephalopathy (HE), spontaneous bacterial peritonitis, sepsis, variceal hemorrhage, and renal dysfunction. Treatment of HD may be difficult as many antihyperglycemic therapies are associated with increased risk of complications in cirrhosis, particularly hypoglycemia. Biguanides, alpha-glucosidase inhibitors, and new medications such as dipeptidyl peptidase-4 inhibitors and sodium-glucose co-transporter 2 inhibitors appear to be safe in patients with cirrhosis. Though insulin therapy is currently advoca Continue reading >>
Prevalence Of Diabetes In Chronic Liver Disease Patient Admitted In Medicine Ward In Rims Hospital, Imphal Perme O, Singh Yi, Singh Kr, Devi Bs, Rao A, Singh Sk - J Med Soc
Context: First study on prevalence of diabetic among chronic liver disease (CLD) patient in Manipur and North-East India as a whole. Aims: To determine the prevalence of diabetes in CLD patient and to correlate the presence of diabetes with clinical features and complications of CLD. Settings and Design: A prospective study was carried out in the Department of Medicine, RIMS, Imphal, from September 2011 to August 2013. Subjects and Methods: Total of 155 cases of CLD who qualify the inclusion criteria was included in analysis. CLD was diagnosed based on history, liver function test, ultrasonography abdomen, and upper gastrointestinal endoscopy. Diabetes diagnosed based on history and who criteria. Statistical Analysis Used: Data obtained from study were analyzed by SPSS Version 16. Results: The prevalence of diabetes was 12.9%. Most common age group was 31-40 years. However, percentage wise diabetes tends to be higher among younger age group 18-30 years groups (27.3%) compared to other age groups. The common clinical findings were ascites (95.5%), pallor (83.8%), and icterus (74.8%). Most common finding among diabetic patient was ascites (95%). Anemia, upper gastrointestinal bleeding, and hepatic encephalopathy (HE) were slightly higher in diabetic group. Conclusions: In this study, prevalence of diabetes was 12.9% among CLD. Complication of CLD was slightly higher among diabetic patient. Presence of diabetes mellitus in patients of CLD post a difficulty in diagnosis as well as management of complications, especially HE. Keywords:Chronic liver disease, complications, diabetes, prevalence Perme O, Singh YI, Singh KR, Devi BS, Rao A, Singh SK. Prevalence of diabetes in chronic liver disease patient admitted in medicine ward in RIMS Hospital, Imphal. J Med Soc 2016;30:84-8 Continue reading >>
Hepatogenous Diabetes: Is It A Neglected Condition In Chronic Liver Disease?
Hepatogenous diabetes: Is it a neglected condition in chronic liver disease? Diego Garca-Compen , Jos Alberto Gonzlez-Gonzlez , Fernando Javier Lavalle-Gonzlez , Emmanuel Irineo Gonzlez-Moreno , Jess Zacaras Villarreal-Prez , and Hctor Jess Maldonado-Garza Diego Garca-Compen, Jos Alberto Gonzlez-Gonzlez, Emmanuel Irineo Gonzlez-Moreno, Hctor Jess Maldonado-Garza, Gastroenterology Service and Department of Internal Medicine, University Hospital Dr. Jos E. Gonzlez and Medical School, Universidad Autnoma de Nuevo Len, Monterrey 64320, Mxico Fernando Javier Lavalle-Gonzlez, Jess Zacaras Villarreal-Prez, Endocrinology Service and Department of Internal Medicine, University Hospital Dr. Jos E. Gonzlez and Medical School, Universidad Autnoma de Nuevo Len, Monterrey 64320, Mxico Author contributions: All the authors contributed equally to the revision of the content of this manuscript; and Garca-Compen D conceived and wrote the editorial. Correspondence to: Diego Garca-Compen, MD, MMSc, Gastroenterology Service and Department of Internal Medicine, University Hospital Dr. Jos E. Gonzlez and Medical School, Universidad Autnoma de Nuevo Len, Madero y Gonzalitos S/N, Monterrey 64320, Mxico. [email protected] Telephone: +52-81-83487315 Fax: +52-81-89891381 Received 2015 Dec 23; Revised 2016 Jan 20; Accepted 2016 Feb 20. Copyright The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved. This article has been cited by other articles in PMC. Diabetes mellitus (DM) that occurs because of chronic liver disease (CLD) is known as hepatogenous diabetes (HD). Although the association of diabetes and liver cirrhosis was described forty years ago, it was scarcely studied for long time. Patients suffering from this condition have low frequency of risk Continue reading >>
Management Of Diabetes In Liver Cirrhosis
Your browser does not support the NLM PubReader view. Go to this page to see a list of supporting browsers. Management of Diabetes in Liver Cirrhosis J Korean Diabetes. 2016 Sep;17(3):159-163. J Korean Diabetes. 2016 Sep;17(3):159-163. Korean. Published online September 30, 2016. Copyright 2016 Korean Diabetes Association Management of Diabetes in Liver Cirrhosis Department of Endocrinology and Metabolism, Chosun University Hospital, Gwangju, Korea. Corresponding author: Jin Hwa Kim. Department of Endocrinology and Metabolism, Chosun University Hospital, 365 Pilmun-daero, Dong-gu, Gwangju 61453, Korea. Email: [email protected] Received July 30, 2016; Accepted August 05, 2016. This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( ) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Diabetes mellitus (DM) is common in patients with liver cirrhosis, indicating a bidirectional relationship between DM and liver cirrhosis. Type 2 DM is a risk factor for development and progression of chronic liver disease including liver cirrhosis, and DM may occur as a complication of liver cirrhosis. Hyperglycemia and hyperinsulinemia have profibrogenic properties on hepatic stellate cells, and contribute to liver damage by promoting inflammation and fibrosis through an increase in mitochodrial oxidative stress mediated by adipokines. The presence of DM in patients with liver cirrhosis is not only related to the poor survival rate but also associated with major complications of cirrhosis. This suggests that optimal management of DM could be beneficial in patients with liver cirrhosis. However, the management of DM in patients with li Continue reading >>
A Different Perspective For Management Of Diabetes Mellitus: Controlling Viral Liver Diseases
A Different Perspective for Management of Diabetes Mellitus: Controlling Viral Liver Diseases Correspondence should be addressed to Huichun Xing ; [email protected] Received 1 December 2016; Revised 21 January 2017; Accepted 30 January 2017; Published 2 March 2017 Copyright 2017 Yingying Zhao and Huichun Xing. This is an open access article distributed under the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Knowing how to prevent and treat diabetes mellitus (DM) earlier is essential to improving outcomes. Through participating in synthesis and catabolism of glycogen, the liver helps to regulate glucose homeostasis. Viral related liver diseases are associated with glycometabolism disorders, which means effective management of viral liver diseases may be a therapeutic strategy for DM. The present article reviews the correlation between DM and liver diseases to give an update of the management of DM rooted by viral liver diseases. Insulin deficiency and/or insulin resistance, which causes glycometabolism disorders, leads to the symptoms of diabetes mellitus (DM). DM is an increasingly recognized global health concern. By 2030, the prevalence of diabetes among adults is expected to rise from 6.4% to 7.7% worldwide. During the next decade, the number of adults with diabetes is expected to rise by 20% in developed nations and 69% in developing nations [ 1 , 2 ]. Long-term complications of DM include micro- and macrovascular damage, which include dysfunction of eyes, kidneys, nerves, gastrointestinal tracts, hearts, and blood vessels. Serious illness or stress can result in acute metabolic disorders, such as diabetic ketoacidosis (DKA) and hyperglycemic hyperosm Continue reading >>
Prevalence Of Glucose Intolerance In Cirrhotics And Risk Factors Predicting Its Progression To Diabetes Mellitus Hanchanale P, Venkataraman J, Jain M, Srinivasan V, Varghese J - J Diabetol
Background: Liver cirrhosis is a unique clinical entity wherein long-standing diabetes mellitus (DM) can predispose an individual to cirrhosis, and on the other hand, a long-standing cirrhosis liver can predispose a cirrhotic to DM, secondary to deranged glucose and insulin metabolism. Aim of the Study: The aim of this study is to determine the prevalence of impaired glucose tolerance (IGT) in patients with liver cirrhosis and risk factors predicting these patients to progression to DM. Materials and Methods: Adult patients above 18 years of age, with a diagnosis of cirrhosis of liver, irrespective of the diabetic status, the aetiology and severity of liver disease, were enrolled for the prospective cross-sectional study. The American Diabetes Association guidelines were followed for classification of DM. Fasting serum insulin assay was done for calculation of homeostatic model assessment insulin resistance (HOMA-IR) with a cut-off of >2.5. Patients with normal baseline glucose tolerance test (GTT) or IGT were followed up prospectively for 6 months at 3 monthly interval. Appropriate statistical tests were applied. Results: Of the 505 cirrhotic patients screened, 158 patients fulfilled the selection criteria. The overall mean age of these 158 patients was 53.3 11.5 years; majority were men (93.7%). As a significant proportion of patients belonged to Child-Turcotte-Pugh (CTP)-C (51.3%) followed by CTP-B and CTP-A. Seventy-four patients had self-reported diabetes (46.8%) at registration. Post-GTT, the prevalence of impaired IGT was 27.4%, and new-onset diabetes mellitus (NODM) was 11.9%. Patients with CTP-C were at greatest risk for either IGT or NODM (P < 0.05). IGT+NODM patients had high median values of 2-h GTT, fasting serum insulin and HOMA-IR compared to non-diabeti Continue reading >>
Diabetes And Liver An Association: Hepatogenous Diabetes Mechanism And Some Evidences
Ajita Acharya, Eden Wudneh, Radhika Krishnan, Aisha Ashraf and Hassaan Tohid* California Institute of Behavioral Neurosciences and Psychology (The Neuro/Cal Institute), University of California, Davis, USA *Corresponding Author: Tohid H, California Institute of Behavioral Neurosciences and Psychology (The Neuro-Cal Institute), 4751 Mengels Blvd, Fairfield, California, 94534, USA, Tel: 707-999-1268; E-mail: [email protected] Citation: Acharya A, Wudneh E, Krishnan R, Ashraf A, Tohid H (2016) Diabetes and Liver an Association: Hepatogenous Diabetes Mechanism and Some Evidences. J Cell Sci Ther 7:257. doi: 10.4172/2157-7013.1000257 Copyright: © 2016 Acharya A, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Visit for more related articles at Journal of Cell Science & Therapy Abstract A literature search was conducted in different databases to study the topic of liver problems and diabetes. The aim of the study was to explore more about an association of diabetes mellitus with the liver. The study shows that diabetes does indeed have an effect on liver. Similarly, liver problems like chronic liver disease lead to diabetes which is known as hepatogenous diabetes. Common liver problems seen in diabetes patients include but not limited to fatty liver, decreased glycogen levels, risk of liver cancer etc. Like any medical problem, any knowledge about any subject is never enough, therefore we recommend more studies in the near future to broaden our understanding about the association of the liver with diabetes. Keywords Diabetes; Diabetes complications; Diabetes and liver; Diabete Continue reading >>
Clinical Implications Of Hepatogenous Diabetes In Liver Cirrhosis.
Clinical implications of hepatogenous diabetes in liver cirrhosis. First Department of Medicine, Klinikum Lippe-Detmold, Rntgenstrasse 18, D-32756 Detmold, Germany. [email protected] Hepatogenous diabetes is a common complication of liver cirrhosis. The aim of the present study was to examine the clinical and therapeutic implications and the prognostic significance of hepatogenous diabetes in patients with liver cirrhosis. The prospective cohort study was conducted in 52 patients with histologically confirmed liver cirrhosis (44% Child A, 37% Child B, 19% Child C). The examination included a history, determination of basal C-peptide and glycosylated hemoglobin (HbA(1c)) and, in some cases, a 3 h oral glucose tolerance test with 100 g glucose. Patients were also examined for signs of diabetic retinopathy and information on the further course of illness was obtained. Seventy-one percent of patients with liver cirrhosis had manifest diabetes, 25% had impaired glucose tolerance and only 4% had normal glucose tolerance. In most cases, the hepatogenous diabetes was clinically asymptomatic. Sixteen percent of patients with hepatogenous diabetes had a family history of diabetes; only 8% had retinopathic complications. Within 5.6 +/- 4.5 years after diagnosis of liver cirrhosis, 52% of the diabetics had died, mainly of complications of the cirrhosis. There were no diabetes-associated or cardiovascular deaths. Hepatogenous diabetes differs from type 2 diabetes in that there is less often a positive family history and that the cardiovascular and retinopathic risk is low. The prognosis of cirrhotic patients with diabetes is more likely to be negatively affected by the underlying hepatic disease and its complications than by the diabetes. Antihyperglycemic treatment of h Continue reading >>
Diabetes And Liver
1. Diabetes and Liver 2. Outline 1. Diabetes and liver -? Vicious cycle 2.Hepatogenous diabetes 3.Elevated transaminases 4.Which agent 3. 1. Diabetes and liver -? Vicious cycle 2.Hepatogenous diabetes 3.Elevated transaminases 4.Which agent 4. The putative mechanisms underlying the contribution of NAFLD to the increased risk of developing CVD and T2DM Anstee, Q. M. et al. (2013) Progression of NAFLD to diabetes mellitus, cardiovascular disease or cirrhosis Nat. Rev. Gastroenterol. Hepatol. doi:10.1038/nrgastro.2013.41 5. Anstee, Q. M. et al. (2013) Progression of NAFLD to diabetes mellitus, cardiovascular disease or irrhosis Nat. Rev. Gastroenterol. Hepatol. doi:10.1038/nrgastro.2013.41 6. 1. Diabetes and liver -? Vicious cycle 2.Hepatogenous diabetes 3.Elevated transaminases 4.Which agent 7. Hyperinsulinaemia Down regulation of insulin receptors 8. • Hepatogenous diabetes differs from type 2 diabetes in that there is less often a positive family history and that the cardiovascular and retinopathic risk is low. • The prognosis of cirrhotic patients with diabetes is more likely to be negatively affected by the underlying hepatic disease and its complications than by the diabetes. 9. • Liver transplantation did not correct the diabetes in one-third of patients with hepatogenous diabetes undergoing transplantation. • HbA 1c is an unreliable - undetected bleeding episodes - hemolysis due to hypersplenism are frequent in • Using a fructosamine test in addition to blood glucose self-monitoring may provide a more suitable assessment of metabolic control. 10. • no dietary restrictions should be prescribed for patients with hepatogenous diabetes. The survival of patients with liver cirrhosis depends on an adequate calorie intake; a hypocaloric diet even leads to incre Continue reading >>
Hepatogenous Diabetes In Liver Cirrhosis
Background: Disturbances of glucose metabolism, eg glucose intolerance or hepatogenous diabetes, occur frequently in patients with liver cirrhosis. They are caused by loss of hepatocellular function and insulin resistance due to chronic liver disease. Discussion: Until now there are no recommendations or guidelines regarding diagnosis and treatment of hepatogenic diabetes. Basic treatment should guarantee sufficient daily energy and protein intakes since the majority of patients with liver cirrhosis are malnourished. The risk of hypoglycaemia must be carefully considered when treating hepatogenic diabetes. Suitable oral antidiabetics are glinides, DPP4-inhibitors, and GLP1 analogues. However, there are no data from clinical studies so far. If sufficient control of diabetes cannot be achieved by oral antidiabetics prandial insulin therapy using short-acting insulins or rapid-acting insulin analogues should be applied. Conclusion: Optimisation of metabolic control is not only important to avoid typical late diabetic but also cirrhosis-associated complications, eg, gastrointestinal bleeding, hepatic encephalopathy, or the occurrence of hepatocellu lar carcinoma. Do you want to read the rest of this article? Continue reading >>
The Successful Treatment Of Hepatogenous Diabetes Due To Alcoholic Liver Cirrhosis With Thrice-daily Preprandial Exenatide, A Short-acting Glp-1 Analog: A Case Report
The Successful Treatment of Hepatogenous Diabetes Due to Alcoholic Liver Cirrhosis With Thrice-Daily Preprandial Exenatide, a Short-Acting GLP-1 Analog: A Case Report Department of Diabetes and Endocrine Medicine, National Hospital Organization Kagoshima Medical Center Department of Diabetes and Endocrine Medicine, Kagoshima University Graduate School of Medical and Dental Science Department of Diabetes and Endocrine Medicine, National Hospital Organization Kagoshima Medical Center Department of Diabetes and Endocrine Medicine, National Hospital Organization Kagoshima Medical Center Department of Diabetes and Endocrine Medicine, Kagoshima University Graduate School of Medical and Dental Science Department of Diabetes and Endocrine Medicine, National Hospital Organization Kagoshima Medical Center Department of Diabetes and Endocrine Medicine, Kagoshima University Graduate School of Medical and Dental Science Released on J-STAGE: July 30, 2017 [Advance Publication] Released: - Received: December 20, 2016 Revised: - Accepted: March 21, 2017 We describe the case of a 67-year-old man with hepatogenous diabetes caused by alcoholic cirrhosis. He was admitted to our hospital due to hyperglycemia (HbA1c 9.4 %) and basal-bolus-therapy was initiated. Although the dose of insulin lispro was increased to 64 U/day, the patient's postprandial hyperglycemia persisted due to insulin resistance, which was associated with cirrhosis. Insulin was discontinued because the patient had allergic reactions to insulin at the injection site during insulin therapy and liraglutide and voglibose combination therapy was started. However, the patient's post-lunch and post-dinner hyperglycemia showed no improvement. Thus, exenatide treatment (three daily injections before each meal) was started. Therea Continue reading >>
Hepatogenous Diabetes: Is It Time To Separate It From Type 2 Diabetes?
Hepatogenous diabetes: Is it time to separate it from type 2 diabetes? Emanuela Orsi - IRCCS C GrandaOspedale Maggiore Policlinico Foundation University of Milan Diabetes Service Milan Italy, University of Milan Valeria Grancini - IRCCS C GrandaOspedale Maggiore Policlinico Foundation University of Milan Diabetes Service Milan Italy, University of Milan Stefano Menini - Sapienza University of Rome, Azienda Ospedaliera Sant'Andrea Alessio Aghemo - IRCCS C GrandaOspedale Maggiore Policlinico Foundation University of Milan Division of Gastroenterology and Hepatology Milan Italy Giuseppe Pugliese - Sapienza University of Rome, Azienda Ospedaliera Sant'Andrea By definition, hepatogenous diabetes is directly caused by loss of liver function, implying that it develops after cirrhosis onset. Therefore, it should be distinguished from type 2 diabetes developing before cirrhosis onset, in which specific causes of liver disease play a major role, in addition to traditional risk factors. Currently, although hepatogenous diabetes shows distinct pathophysiological and clinical features, it is not considered as an autonomous entity. Recent evidence suggests that the failing liver exerts an independent "toxic" effect on pancreatic islets resulting in -cell dysfunction. Moreover, patients with hepatogenous diabetes usually present with normal fasting glucose and haemoglobin A1c levels and abnormal response to an oral glucose tolerance test, which is therefore required for diagnosis. This article discusses the need to separate hepatogenous diabetes from type 2 diabetes occurring in subjects with chronic liver disease and to identify individuals suffering from this condition for prognostic and therapeutic purposes. 2018 Digital Science & Research Solutions, Inc. All Rights Reserved | Abo Continue reading >>
Diabetes In Chronic Liver Disease
Researchers in Vienna have made a breakthrough with synthetic bile acids in the treatment of primary sclerosing cholangitis. These compounds could feasibly be of use in fatty liver and diabetes – but would require further study. “Bile acids are not only involved in the secretion of bile fluids and fat digestion, but also have hormone-like effects, particularly on the regulation of fat and glucose metabolism in the liver. Researchers at the MedUni Vienna are currently also investigating what role these effects of Nor-Urso [norursodeoxycholic acid] and other bile acid derivatives play in the treatment of fatty liver, diabetes, fat metabolism problems and arteriosclerosis and how they could replace current conventional treatment methods and drugs.” This news is interesting and it reminds us of the strong link between diabetes and the liver. What is this relationship and what are the implications for clinical practice? The liver plays an important role in the regulation of glucose homeostasis. This helps explain why glucose intolerance is a feature or complication of chronic liver disease and cirrhosis. Liver disease associated with diabetes mellitus can be divided into three groups as shown below [1]: 1. Liver disease occurring as a consequence of diabetes mellitus • Glycogen deposition • Steatosis and nonalcoholic steatohepatitis (NASH) • Fibrosis and cirrhosis • Biliary disease, cholelithiasis, cholecystitis • Complications of therapy of diabetes (cholestatic and necroinflammatory) 2 . Diabetes mellitus and abnormalities of glucose homeostasis occurring as a complication of liver disease • Hepatitis • Cirrhosis • Hepatocellular carcinoma • Fulminant hepatic failure • Postorthotopic liver transplantation 3 . Liver disease occurring coincidentally Continue reading >>
Clinical Implications Of Hepatogenous Diabetes In Liver Cirrhosis
Hepatogenous diabetes is a common complication of liver cirrhosis. The aim of the present study was to examine the clinical and therapeutic implications and the prognostic significance of hepatogenous diabetes in patients with liver cirrhosis.The prospective cohort study was conducted in 52 patients with histologically confirmed liver cirrhosis (44% Child A, 37% Child B, 19% Child C). The examination included a history, determination of basal C-peptide and glycosylated hemoglobin (HbA(1c)) and, in some cases, a 3 h oral glucose tolerance test with 100 g glucose. Patients were also examined for signs of diabetic retinopathy and information on the further course of illness was obtained.Seventy-one percent of patients with liver cirrhosis had manifest diabetes, 25% had impaired glucose tolerance and only 4% had normal glucose tolerance. In most cases, the hepatogenous diabetes was clinically asymptomatic. Sixteen percent of patients with hepatogenous diabetes had a family history of diabetes; only 8% had retinopathic complications. Within 5.6 +/- 4.5 years after diagnosis of liver cirrhosis, 52% of the diabetics had died, mainly of complications of the cirrhosis. There were no diabetes-associated or cardiovascular deaths.Hepatogenous diabetes differs from type 2 diabetes in that there is less often a positive family history and that the cardiovascular and retinopathic risk is low. The prognosis of cirrhotic patients with diabetes is more likely to be negatively affected by the underlying hepatic disease and its complications than by the diabetes. Antihyperglycemic treatment of hepatogenous diabetes should always be carefully weighed up in each individual case. Do you want to read the rest of this article? ... Diabetes that develops as a complication of cirrhosis of liver Continue reading >>
Diabetes Mellitus Is Associated With Gastroesophageal Variceal Bleeding In Cirrhotic Patients - Sciencedirect
Volume 30, Issue 10 , October 2014, Pages 515-520 Diabetes mellitus (DM) has been reported to increase the risk of complications of liver cirrhosis of any etiology and subsequent survival. However, the impact of DM on the development of gastroesophageal variceal bleeding (GEVB) remains unclear. We aimed to elucidate whether DM is an independent risk factor for GEVB among cirrhotic patients. A total of 146 consecutive patients with liver cirrhosis (Child-Pugh Class A, n=75; Class B, n=40; and Class C, n=31) were prospectively enrolled. Data on clinical and biochemical characteristics and history of ascites, GEVB, hepatic encephalopathy, and spontaneous bacterial peritonitis were retrospectively reviewed. Of these 146 patients, 37 (25%) had DM. Patients with DM had significantly higher ratio of Child-Pugh Class B/C (p=0.043), renal insufficiency (p=0.002), and history of GEVB (p=0.006) compared with non-DM patients. GEVB was associated with Child-Pugh Class B/C (p=0.001), ascites (p=0.002), hepatic encephalopathy (p=0.023), and low platelet counts (p<0.001). Based on stepwise multiple logistic regression analysis, Child-Pugh class B/C [odds ratio (OR)=4.90, p=0.003] and DM (OR=2.99, p=0.022) were identified as independent predictors of GEVB. In the subgroup analysis, DM significantly correlated with GEVB in patients with Child-Pugh Class A (p=0.042), but not in patients with Child-Pugh Class B/C (p=0.128). DM is independently associated with GEVB in cirrhotic patients, especially in those with Child-Pugh Class A. Continue reading >>
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