Chattopadhyay P S, Chattopadhyay R, Goswami R, Gupta S K
Department of Nutrition and Metabolic Diseases, School of Tropical Medicine, Calcutta.
Indian J Pathol Microbiol. 1998 Apr;41(2):141-6.
Investigations of liver function and histology were undertaken in thirty four patients with Fibrocalculous Pancreatic Diabetes (FCPD). The data obtained were compared with those of similarly aged members of a diabetic control group comprising twelve patients with Protein Deficient Diabetes Mellitus (PDDM), twelve with Type 1 diabetes or Insulin Dependent Diabetes Mellitus (IDDM) and four young patients with Type 2 Diabetes of Non-Insulin Dependent Diabetes Mellitus (NIDDM). None of them had apparent past or present liver disease. Elevations of serum ALT (SGPT) and alkaline phosphatase levels were fairly common and was often associated with mild fatty changes and occasionally with focal necrosis and inflammatory changes. Cirrhosis and inflammatory changes per se were infrequent and fatty changes per se did not occur. In contrast patients belonging to the other diabetic subsets were very occasionally afflicted with hepatic abnormalities or not afflicted at all. We propose that loss of hepatotrophic actions mediated by insulin and glucagon could initiate and/or enhance hepatic abnormalities in FCPD where deficiencies of insulin and glucagon coexist.
对34例纤维钙化性胰腺糖尿病（FCPD）患者进行了肝功能和组织学检查。将获得的数据与糖尿病对照组中年龄相仿的成员的数据进行比较，该对照组包括12例蛋白质缺乏性糖尿病（PDDM）患者、12例1型糖尿病或胰岛素依赖型糖尿病（IDDM）患者以及4例2型非胰岛素依赖型糖尿病（NIDDM）的年轻患者。他们中没有人有明显的既往或当前肝脏疾病。血清ALT（SGPT）和碱性磷酸酶水平升高相当常见，且常与轻度脂肪变性相关，偶尔与局灶性坏死和炎症改变有关。肝硬化和炎症改变本身并不常见，脂肪变性本身也未发生。相比之下，其他糖尿病亚组的患者很少出现肝脏异常或根本没有肝脏异常。我们认为，在胰岛素和胰高血糖素均缺乏的FCPD中，由胰岛素和胰高血糖素介导的肝营养作用丧失可能引发和/或加重肝脏异常。
