Fraser G M, Harman I, Meller N, Niv Y, Porath A
Department of Gastroenterology, Beilinson Medical Center, Petah Tikva, Israel.
Isr J Med Sci. 1996 Jul;32(7):526-30.
Glucose intolerance is associated with chronic liver disease, particularly cirrhosis, and overt diabetes mellitus is two to four times more common than in the general population. Little attention has been paid to the relationship between the cause of cirrhosis and the development of glucose intolerance or whether cirrhosis is a prerequisite. We found glucose intolerance to be particularly common in patients with chronic hepatitis C, and in this retrospective study we attempt to confirm this possible association. To investigate this question we reviewed the files of 128 patients with chronic hepatitis C and 40 with chronic hepatitis B and active liver disease. Demographic, laboratory, imaging and pathology data were abstracted. The mean fasting blood glucose (+/-SD) in the hepatitis C and B groups was 160 +/- 83 and 103 +/- 18 mg/dl (P < 0.0001) with 2.5% and 39.1% respectively being overtly diabetic (P < 0.00001). However, the mean age of the hepatitis C group was much higher (45.6 +/- 12.5 vs. 60.1 +/- 12.3 years, P < 0.00001). The prevalence of diabetes was much higher among the hepatitis C patients than in the general population. Cirrhosis was not more frequent in biopsies from hepatitis C diabetic patients compared with non-diabetic or hepatitis B patients. Multivariate analysis showed that type of hepatitis and age were significant and independent predictors for developing diabetes. We conclude that there appears to be an association between diabetes mellitus and chronic hepatitis C that is not present in patients with chronic hepatitis B.
葡萄糖耐量异常与慢性肝病相关，尤其是肝硬化，显性糖尿病的发生率比普通人群高两到四倍。肝硬化病因与葡萄糖耐量异常的发生之间的关系，或者肝硬化是否是一个先决条件，很少受到关注。我们发现葡萄糖耐量异常在慢性丙型肝炎患者中尤为常见，在这项回顾性研究中，我们试图证实这种可能的关联。为了研究这个问题，我们查阅了128例慢性丙型肝炎患者和40例慢性乙型肝炎及活动性肝病患者的病历。提取了人口统计学、实验室、影像学和病理学数据。丙型肝炎组和乙型肝炎组的平均空腹血糖（±标准差）分别为160±83和103±18mg/dl（P<0.0001），显性糖尿病患者分别为2.5%和39.1%（P<0.00001）。然而，丙型肝炎组的平均年龄要高得多（45.6±12.5岁对60.1±12.3岁，P<0.00001）。丙型肝炎患者中糖尿病的患病率比普通人群高得多。与非糖尿病患者或乙型肝炎患者相比，丙型肝炎糖尿病患者活检中肝硬化的发生率并不更高。多变量分析表明，肝炎类型和年龄是发生糖尿病的重要且独立的预测因素。我们得出结论，糖尿病与慢性丙型肝炎之间似乎存在关联，而慢性乙型肝炎患者不存在这种关联。
