Verlohren H J, Lohmann D
Z Gesamte Inn Med. 1977 Jan 1;32(1):34-7.
Statistically there exists an increased coincidence between liver cirrhosis and diabetes mellitus. The higher frequency of cirrhosis in diabetics compared with the normal population is to be explained partly from the higher risk of hepatitis. In addition to this the diabetic suffers from disturbances which further the development of cirrhosis, such as fatty degeneration of the liver, abuse of alcohol, more frequent inflammatory diseases of the bile duct and others. When a diabetes mellitus exists in liver cirrhosis it is to be differed between a diabetes due to absolute or relative insulin deficit and disturbances of carbohydrate clearance which are associated with normal or increased insulin levels. The latter form can be denoted as so-called liver diabetes. Main cause of this carbohydrate intolerance is an insulin resistance, partly by deminution of the metabolically active liver parenchyma, partly by the diminished reactivity of the peripheral tissues. By prophylactic measures and differentiated therapy may be favourably influenced lesions of the liver in diabetes mellitus as well as disturbances of the carbohydrate metabolism.
从统计学角度来看，肝硬化与糖尿病之间的并发率有所增加。与正常人群相比，糖尿病患者中肝硬化的发生率较高，部分原因是肝炎风险较高。除此之外，糖尿病患者还存在一些促进肝硬化发展的紊乱情况，如肝脏脂肪变性、酗酒、胆管炎症性疾病更为频发等。当肝硬化患者同时患有糖尿病时，需要区分是由于绝对或相对胰岛素缺乏导致的糖尿病，还是与胰岛素水平正常或升高相关的碳水化合物清除障碍。后一种形式可称为所谓的肝源性糖尿病。这种碳水化合物不耐受的主要原因是胰岛素抵抗，部分是由于代谢活跃的肝实质减少，部分是由于外周组织反应性降低。通过预防措施和个体化治疗，糖尿病患者的肝脏病变以及碳水化合物代谢紊乱可能会得到有利影响。
