Shlimovich P B, Zus' B A, Evdokimov A R
Probl Endokrinol (Mosk). 1977 Jul-Aug;23(4):7-14.
Peculiarities of clinical picture of diabetes mellitus in its combination with chronic hepatitis and cirrhosis of the liver were studied in 60 patients. Diabetes mellitus developed mostly against the background of chronic affection of the liver, preceding it. Glucose tolerance disturbances according to the type of latent and manifest diabetes were revealed in 28% of 132 patients with chronic hepatitis and cirrhosis of the liver. Histological study of the pancreas in 63 patients who died of cirrhosis of the liver demonstrated marked fibrosis of hepatic parenchyma without any noticeable changes in the pancreatic islets. The blood insulin and growth hormone levels were significantly greater in 132 patients examined than in healthy persons. The mentioned changes in the glycemia level, of the insulin and growth hormone level after glucose administration were more pronounced in cirrhosis of the liver than in chronic hepatitis, and in late stages of portal cirrhosis than at its early stages. The leading role played by insulin sensitivity reduction of the peripheral tissues in the pathogenesis of carbohydrate metabolism in cases with chronic diseases of the liver is supposed.
对60例糖尿病合并慢性肝炎和肝硬化患者的临床症状特点进行了研究。糖尿病大多在肝脏慢性病变的基础上发生，且先于肝脏病变。在132例慢性肝炎和肝硬化患者中，28%出现了潜伏性和显性糖尿病类型的糖耐量异常。对63例死于肝硬化的患者的胰腺进行组织学研究发现，肝实质有明显纤维化，而胰岛无明显变化。在接受检查的132例患者中，血液胰岛素和生长激素水平显著高于健康人。上述血糖水平、葡萄糖给药后胰岛素和生长激素水平的变化在肝硬化患者中比在慢性肝炎患者中更明显，在门静脉性肝硬化晚期比早期更明显。推测在肝脏慢性病患者碳水化合物代谢的发病机制中，外周组织胰岛素敏感性降低起主要作用。
