Del Vecchio Blanco C, Gentile S, Marmo R, Carbone L, Coltorti M
Cattedra di Clinica Medica II, 1st School of Medicine, University of Naples, Naples, Italy.
Diabetes Res Clin Pract. 1990 Jan;8(1):29-36. doi: 10.1016/0168-8227(90)90093-9.
The prevalence of glucose intolerance has been studied by oral glucose tolerance test in 670 patients affected by chronic liver disease. The glycometabolic status was evaluated by criteria given by WHO in 1980. Sixty-nine subjects appeared to be affected by chronic persistent hepatitis and 140 by chronic active hepatitis. In these patients the prevalence of diabetic responses (DR) did not differ much from that of the general population in our geographic area. In contrast, a markedly higher frequency of DR appeared in a cirrhotic group of 401 patients compared to non-cirrhotic subjects. The cirrhotics, divided according to different disease stages, showed a higher DR frequency in decompensated patients than in well compensated patients, the prevalence reaching 63% in the former subgroup. The coincident presence of hepatocarcinoma - documented in 60 other cirrhotic patients - does not modify the prevalence of diabetes. Other risk factors for diabetes such as age, sex, and family history have been considered. Our results suggest that: (1) all these factors seem not to play a major role in the pathogenesis of alterations of glucose metabolism in patients suffering from chronic liver disease, and therefore (2) liver cirrhosis by itself might be a risk factor in the disturbance of glucose tolerance.
通过口服葡萄糖耐量试验，对670例慢性肝病患者的葡萄糖不耐受患病率进行了研究。根据世界卫生组织1980年给出的标准评估糖代谢状态。69名受试者患有慢性持续性肝炎，140名患有慢性活动性肝炎。在这些患者中，糖尿病反应（DR）的患病率与我们地理区域的普通人群没有太大差异。相比之下，401例肝硬化患者组的DR频率明显高于非肝硬化患者。根据不同疾病阶段划分的肝硬化患者，失代偿期患者的DR频率高于代偿良好的患者，在前一亚组中患病率达到63%。另外60例肝硬化患者中记录到的肝癌并存情况，并未改变糖尿病的患病率。还考虑了糖尿病的其他风险因素，如年龄、性别和家族史。我们的结果表明：（1）所有这些因素似乎在慢性肝病患者糖代谢改变的发病机制中不起主要作用，因此（2）肝硬化本身可能是葡萄糖耐量紊乱的一个危险因素。
