Sayed Moayad Alavian, Behzad Hajarezadeh, Friborz Nematizadeh, Bagher Larijani,
Volume 3, Issue 1 (5-2004)
Abstract
Alterations in carbohydrate metabolism are frequently observed in cirrhosis. We conducted this study to define the prevalence of diabetes mellitus (DM) and impaired glucose tolerance (IGT) in patients with chronic liver disease (CLD), and explore the factors that may be potentially associated with the development of DM in these patients.
Methods: From October 2002 to March 2003, 185 consecutive patients with CLD, who referred to "Tehran Hepatitis Center", were enrolled into the study. Fasting plasma glucose and two-hour plasma glucose were measured in patients' sera. DM and IGT were diagnosed according to latest American Diabetes Association criteria.
Results: The subjects included 42 inactive HBV carriers, 102 patients with HBV or HCV chronic hepatitis, and 41 cirrhotic patients. Mean age was 43.8±12.0 years ranging between 22 to 84 years. DM and IGT were diagnosed in 40 (21.6%) and 21(11.4%) patients, respectively. Univariate analysis showed that age (P=0.000), CLD status (P=0.000), history of hypertension (P=0.007), family history of DM (P=0.000), and body mass index (BMI) (P=0.009) were associated with DM. Using Multivariate analysis, age (P=0.01), family history of DM (P=0.0001), chronic hepatitis (0.0004), and cirrhosis (P=0.0004) remained as the factors independently associated with DM. When patients with cirrhosis and chronic hepatitis were analyzed separately, higher Child-Pugh's score in cirrhosis (P=0.04) and older age (P=0.04), higher fibrosis score (P=0.04), and higher BMI (P=0.003) in patients with chronic hepatitis were found to be associated with higher prevalence of DM. Conclusion: Our findings indicated that patients with cirrhosis and chronic hepatitis are at risk of developing DM. Older age, sever liver disease, and obesity were associated with development of DM.
Shahram Safa, Alireza Esteghamati, Mohsen Nasiri Tousi, Hosein Foroutan, Hadi Ghofrani, Akram Sarbyaei, Mehrshad Abbasi,
Volume 5, Issue 2 (9-2005)
Abstract
Background: The liver plays a main role in the production and metabolism of lipoproteins, and then impaired lipid metabolism is often seen in patients with liver cirrhosis and chronic hepatitis (CH). As a result, plasma lipid levels could be as useful indicators of liver function and patient's prognosis especially in liver cirrhosis.
Methods: We measured the lipoprotein levels in 77 consecutive patients with liver cirrhosis and CH. 47 men (61%) and 30 women (39%) with mean age 43years (SD=16.4) and mean BMI 26(SD=4.2) have been recruited as patients group. Child score and MELD scale was determined in patients group. The control group was age and sex matched with patients group.
Results: In case group, the levels of HDL LDL, TG, and total cholesterol were significantly lower than control group (p <0.0001). In patients with cirrhosis, the levels of LDL, HDL and total cholesterol were progressively lower when comparing patients in Child class A with patients in class C (p<0.0001).This difference was more significant in LDL and total cholesterol and between upper Child scores ,similarly decreasing in LDL, HDL ,and total cholesterol level was observed when MELD score increased (P<0.0001).
Conclusion: There is a correlation between plasma lipid levels and liver function, so it may be mentioned as an accessible and reliable indicator of liver function in cirrhotic and CH patients.
