Department of Surgery, University of Auckland, Auckland, New Zealand.
Section of Surgery, Department of Medical and Surgical Sciences, University of Otago, Dunedin, New Zealand.
Diabetes Metab Res Rev. 2019 Sep;35(6):e3157. doi: 10.1002/dmrr.3157. Epub 2019 Apr 23.
An association between diabetes mellitus (DM) and liver cirrhosis is well-known, but estimates of the prevalence of DM in patients with liver cirrhosis vary widely. A systematic review was undertaken to determine the prevalence of DM in adult patients with liver cirrhosis. The Medline, EMBASE, and Cochrane Library databases were searched for peer-reviewed studies published in English (1979-2017) that investigated the prevalence of diabetes in adult patients with cirrhosis. Pooled estimates of prevalence of DM were determined for all eligible patients and according to aetiology and severity of liver disease. Fifty-eight studies satisfied criteria for inclusion, with 9705 patients included in the pooled prevalence analysis. The overall prevalence of DM was 31%. The prevalence of DM was highest in patients with nonalcoholic fatty liver disease (56%), cryptogenic (51%), hepatitis C (32%), or alcoholic (27%) cirrhosis. For assessing prevalence of DM as a function of severity of liver disease, evaluable data were available only for hepatitis C and hepatitis B cirrhosis. DM may be more prevalent in cirrhosis than previously thought. This has implications for prognosis and treatment in these patients.
糖尿病（DM）与肝硬化之间的关联是众所周知的，但肝硬化患者中 DM 的患病率估计差异很大。进行了系统评价，以确定肝硬化成年患者中 DM 的患病率。检索了 Medline、EMBASE 和 Cochrane Library 数据库中以英文发表的（1979-2017 年）关于调查肝硬化成年患者糖尿病患病率的同行评议研究。根据病因和肝病严重程度，确定了所有合格患者和 DM 流行率的汇总估计值。58 项研究符合纳入标准，共有 9705 例患者纳入汇总流行率分析。DM 的总体患病率为 31%。非酒精性脂肪性肝病（56%）、隐源性（51%）、丙型肝炎（32%）或酒精性（27%）肝硬化患者的 DM 患病率最高。为了评估 DM 作为评估肝脏疾病严重程度的函数的流行率，仅可评估丙型肝炎和乙型肝炎肝硬化的数据。DM 在肝硬化中的流行率可能比以前认为的要高。这对这些患者的预后和治疗有影响。
