Carotid intima-media thickness in patients with liver cirrhosis associated with diabetes mellitus.

OBJECTIVE

In patients with liver cirrhosis (LC), the incidence of diabetes mellitus (DM) is high, whereas that of hypertension and ischemic heart diseases is low. We measured carotid artery intima-media thickness (IMT) to determine the incidence of atherosclerosis in patients with LC+DM and to compare it with that in patients with type 2 DM, and evaluated the risk factors for atherosclerosis in these patients.

RESEARCH DESIGN AND METHODS

We determined IMT of the common carotid artery by B-mode ultrasound, serum lipid levels, C-reactive protein (CRP), plasma levels of fasting and postprandial glucose, glycated hemoglobin (HbA1c), fibrinogen and platelet counts in 14 patients of the LC+DM group, 16 patients with type 2 DM (DM group) and 14 patients with LC without impaired glucose tolerance (LC group).

RESULTS

The IMT in the LC+DM group (0.694+/-0.175mm) was similar to that in the LC group (0.693+/-0.151mm) but significantly smaller than the DM group (0.904+/-0.337mm). There were no significant differences between the LC+DM group and DM group in the duration of DM, proportion of smokers, arterial blood pressure, fasting and postprandial plasma glucose levels, and CRP, but HbA1c, platelet counts and fibrinogen were significantly lower in the LC+DM group than in the DM group.

CONCLUSIONS

Our study suggests that the development of atherosclerosis in patients with DM is suppressed by the presence of LC, probably due to reduced platelet counts and fibrinogen levels.