Effect of diabetes on mortality and liver transplantation in alcoholic liver cirrhotic patients with acute decompensation

Jihye Lim ¹, Sung-Eun Kim ², Ae Jeong Jo ³

¹Division of Gastroenterology and Hepatology, Department of Internal Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
²Division of Gastroenterology and Hepatology, Department of Internal Medicine, Hallym Medical Center, Hallym University College of Medicine, Chuncheon, 24252, Republic of Korea. sekim@hallym.or.kr.
³Department of Information Statistics, Andong National University, Andong-si, Republic of Korea.
⁴Division of Gastroenterology and Hepatology, Department of Internal Medicine, Hallym Medical Center, Hallym University College of Medicine, Chuncheon, 24252, Republic of Korea.
⁵Division of Gastroenterology and Hepatology, Department of Internal Medicine, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, Ilsanro, Wonju, 26426, Republic of Korea.
⁶Division of Gastroenterology, Department of Internal Medicine, Korea University Medical Center, Seoul, Republic of Korea.
⁷Division of Gastroenterology and Hepatology, Department of Internal Medicine, Hanyang University College of Medicine, Seoul, 04763, Republic of Korea.
⁸Division of Gastroenterology and Hepatology, Department of Internal Medicine, Soonchunhyang University College of Medicine, Seoul, 04401, Republic of Korea.
⁹Division of Gastroenterology and Hepatology, Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Bucheon, 14584, Republic of Korea.
¹⁰Division of Gastroenterology and Hepatology, Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, 42415, Republic of Korea.
¹¹Department of Internal Medicine, Inha University Hospital, Inha University School of Medicine, Incheon, Republic of Korea.
¹²Division of Gastroenterology and Hepatology, Department of Internal Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, 07061, Republic of Korea.

⁰Division of Gastroenterology and Hepatology, Department of Internal Medicine, The Catholic University of Korea, Seoul, Republic of Korea.

Hepatology International +

|

July 17, 2024

View abstract on PubMed

Summary

Diabetes significantly increases the risk of death or liver transplantation in patients with alcoholic liver cirrhosis. This study highlights the critical impact of diabetes on outcomes for this vulnerable patient group.

Area Of Science

Hepatology
Endocrinology
Clinical Medicine

Background

The impact of diabetes on patients with alcoholic liver cirrhosis remains unclear.
Previous studies have not definitively established this association.
Further investigation is needed to clarify the role of diabetes in this patient population.

Purpose Of The Study

To investigate the association between diabetes and clinical outcomes in patients with alcoholic liver cirrhosis.
To assess the risk of death or liver transplantation in patients with and without diabetes.
To provide clarity on the influence of diabetes on alcoholic liver cirrhosis prognosis.

Main Methods

Prospective data collection from 965 patients with alcoholic liver cirrhosis admitted for acute decompensation (2015-2019).
Comparative assessment of mortality and liver transplantation incidence between diabetic and non-diabetic patients.
Propensity score (PS) matching (1:2 ratio) for robust comparative analysis.

Main Results

Diabetes was present in 23.6% of the cohort; positively correlated with hepatic encephalopathy and GI bleeding (not significant).
Higher incidence of death or liver transplantation observed in diabetic patients (33.6/100 PYs) vs. non-diabetic (24.0/100 PYs).
PS-matched analysis confirmed significantly higher risk (36.8/100 PYs vs. 18.6/100 PYs) and adverse clinical indicators in diabetic patients.

Conclusions

Coexisting diabetes significantly elevates the risk of death or liver transplantation in alcoholic liver cirrhosis patients.
Diabetes is associated with poorer short-term and long-term outcomes.
Management of diabetes is crucial for improving prognosis in alcoholic liver cirrhosis.

Keywords:

Alcohols Death Diabetes mellitus Esophageal and gastric varices Hepatic encephalopathy Jaundice Liver cirrhosis Liver transplantation Precipitating factor Prognosis

Related Concept Videos

Diabetes: Symptoms, Diagnosis, and Complications

For most patients, experiencing several weeks of polyuria, polydipsia, fatigue, and significant weight loss may indicate the presence of diabetes. Furthermore, adults displaying the phenotypic appearance of type 2 diabetes (particularly those who are obese and not initially insulin-requiring), may have islet cell autoantibodies, suggesting autoimmune-mediated β cell destruction and a diagnosis of latent autoimmune diabetes of adults (LADA). The categorization of glucose homeostasis is...