Ichikawa Tatsuki, Taura Naota, Miyaaki Hisamitsu, Miuma Satoshi, Shibata Hidetaka, Honda Takuya, Hidaka Masaaki, Soyama Akihiko, Takatsuki Mitsuhisa, Eguchi Susumu, Nakao Kazuhiko
Department of Gastroenterology and Hepatology, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki 852-8501, Japan; Department of Gastroenterology, Nagasaki Harbor Medical Center, Nagasaki 850-8555, Japan.
Department of Gastroenterology and Hepatology, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki 852-8501, Japan.
Biomed Rep. 2016 Dec;5(6):749-757. doi: 10.3892/br.2016.788. Epub 2016 Oct 21.
Liver cirrhosis and diabetes mellitus (DM) are closely associated. The present study aimed to determine whether liver transplantation (LT) may prevent/cure DM in patients with cirrhosis and whether the degree of glucose tolerance prior to transplantation is associated with the onset of DM after transplantation. Seventy-three patients who received a living donor LT at Nagasaki University Hospital (Nagasaki, Japan) between November 2005 and December 2012 were recruited. Among them, patients were considered diabetic if they had been prescribed diabetes medications or had impaired glucose tolerance, as evidenced by an oral glucose tolerance test (OGTT). Patients were followed up until December 31, 2013 to evaluate glucose tolerance. Patients who had developed DM 2 years after transplantation were found to be older and the incidence of diabetes prior to transplantation (n=73) was higher than in those who did not. Multivariate analysis revealed that DM requiring treatment prior to transplantation was the only independent factor for DM developed at 2 years after transplantation. OGTT results showed that in patients with poor insulin sensitivity indices prior to transplantation (n=45), improvements were seen at 2 years after transplantation, while β-cell function and insulinogenic index had decreased, which may have been the cause of DM after transplantation. In conclusion, the pre-operative β-cell function determined by an OGTT may be a useful predictive tool for the recurrence of DM after LT.
肝硬化与糖尿病（DM）密切相关。本研究旨在确定肝移植（LT）是否可预防/治愈肝硬化患者的糖尿病，以及移植前的糖耐量程度是否与移植后糖尿病的发生有关。招募了2005年11月至2012年12月期间在日本长崎大学医院接受活体供肝肝移植的73例患者。其中，如果患者曾服用糖尿病药物或口服葡萄糖耐量试验（OGTT）显示糖耐量受损，则被视为糖尿病患者。对患者进行随访至2013年12月31日，以评估糖耐量。发现移植后2年发生糖尿病的患者年龄较大，移植前糖尿病的发生率（n = 73）高于未发生糖尿病的患者。多因素分析显示，移植前需要治疗的糖尿病是移植后2年发生糖尿病的唯一独立因素。OGTT结果显示，移植前胰岛素敏感性指数较差的患者（n = 45）在移植后2年有所改善，而β细胞功能和胰岛素生成指数下降，这可能是移植后糖尿病的原因。总之，通过OGTT测定的术前β细胞功能可能是肝移植后糖尿病复发的有用预测工具。
