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患有自身免疫性肝炎的患者糖尿病:频率,危险因素和对结果的影响
Sarah Flatley1,2, Selena Dixon1, Eleanor Pilsworth1
1Liver Unit, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK.
Alimentary pharmacology & therapeutics
|May 9, 2025
概括
新发型糖尿病 (DM) 影响了13%的自身免疫性肝炎 (AIH) 患者接受皮质类固醇治疗. 这种情况独立地预测了更糟糕的结果,包括死亡或移植,以及肝硬化发展.
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.
- 临床医学 临床医学
背景情况:
- 皮质类固醇是对自身免疫性肝炎 (AIH) 的标准治疗方法.
- 皮质类固醇使用与新发糖尿病 (DM) 有关.
- 预测因素和AIH中DM的结果尚未得到充分理解.
研究的目的:
- 为了确定在AIH患者中DM的频率.
- 确定易患DM的AIH患者的因素.
- 评估DM与AIH进展和死亡率的关联.
主要方法:
- 一个回顾性/前性单中心研究包括494名AIH患者 (1987-2023年).
- 466名患者接受了皮质类固醇 (普雷迪尼索隆或布索尼德).
- 随访时间的中位数为9年.
主要成果:
- 10%的AIH患者有先前存在的DM;13%的患者患有新发的DM.
- 在服用普雷迪尼索隆10年后,新发的DM发病率为14% (比预期高14倍).
- 新发性DM的危险因素包括年龄较大,非高加索族裔,较高的普雷迪尼索隆剂量,较高的BMI和体重增加. 新发病的DM预测了所有原因的死亡/移植和肝硬化发展.
结论:
- 新发的DM影响了13%的AIH患者,并与特定的风险因素有关.
- 在AIH患者中,DM是死亡率/移植和肝硬化的一个独立预测因素.
- 在AIH中最大限度地减少皮质类固醇的使用对于减少DM发病率和改善患者的治疗结果至关重要.
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