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患有慢性肝病的患者在肝硬化发病之前就有糖尿病的风险
Georgia Bale1, Frédéric Clarembeau2, Peter Stärkel2
1Service d'Hépato-Gastroentérologie, Cliniques universitaires Saint-Luc, UCLouvain, Brussels, Belgium.
Clinics and research in hepatology and gastroenterology
|July 24, 2024
概括
慢性肝病 (CLD) 独立地增加了2型糖尿病 (T2DM) 的风险. 肝硬化进一步提高了胰岛素耐药性,而代谢性肥胖症和C型肝炎构成最大的风险.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 内分泌学 在内分泌学.
- 代谢疾病 代谢疾病
背景情况:
- 胰岛素抵抗 (IR) 和2型糖尿病 (T2DM) 在肝硬化患者中更为普遍.
- 关联肝病和IR/T2DM的潜在机制需要进一步阐明,肝炎是潜在的因素.
研究的目的:
- 调查肝硬化是否是IR的主要原因,或者在非肝硬化慢性肝病 (CLD) 中是否存在胰岛素敏感性受损.
- 为了比较对照,CLD和肝硬化患者群体之间的IR和T2DM患病率.
主要方法:
- 招募的患者分为三个组:对照组 (CTL),没有肝硬化的慢性肝病 (CLD) 和肝硬化 (CIR).
- 在非糖尿病患者中使用恒温模式评估胰岛素抵抗 (HOMA-IR) 量化IR.
- 在各种病因方面比较T2DM患病率和HOMA-IR水平.
主要成果:
- 在三个队列中观察到血糖,胰岛素和HOMA-IR的显著差异 (p<0.001).
- 在CLD患者中的IR水平是CTL和CIR组之间的中间水平.
- 在CLD患者中,T2DM患病率为25%,在CIR患者中为33% (p=0.027).
- 根据病因,HOMA-IR有所不同 (p<0.001),代谢性肥胖症和慢性型肝炎的风险较高.
结论:
- 细胞肝硬化是T2DM的诱导因素,独立于肝硬化.
- 肝硬化会加剧胰岛素水平.
- 代谢性肥胖症和型肝炎与更严重的IR相关.
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