Hepatogenous diabetes in cirrhosis is related to portal pressure and variceal hemorrhage

Hyo Keun Jeon, Moonyoung Kim, Soonkoo Baik, Hong Jun Park, Hoon Choi, So Yeon Park, Bo Ra Kim, Jin Heon Hong, Ki Won Jo, Seung Yong Shin, Jung Min Kim, Jae Woo Kim, Hyunsoo Kim, Sang Ok Kwon, Young Ju Kim, Seung Hwan Cha, Dong Joon Kim, Ki Tae Suk, Gab Jin Cheon, Young Don Kim & 2 others Dae Hee Choi, Sung Joon Lee

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19 Citations (Scopus)

Abstract

Background and Aim: The clinical impact and complications of hepatogenous diabetes (HD) on cirrhosis have not been elucidated. This study aimed to evaluate the relationship of HD with portal hypertension (PHT) and variceal hemorrhage and to assess the prevalence of HD. Methods: From July 2007 to December 2009, 75-g oral glucose tolerance test and insulin resistance (IR) were evaluated for 195 consecutive cirrhotic liver patients (M:F = 164:1, 53.0 ± 10.2 years) who had no history of diabetes mellitus. IR was calculated using the homeostasis model of assessment-insulin resistance (HOMA-IR) formula. Endoscopy for varices, hepatic venous pressure gradient (HVPG), and serologic tests were also conducted. Results: HD was observed in 55.4 % (108/194) of the patients. Among them, 62.0 % required OGTT for diagnosis because they did not show an abnormal fasting plasma glucose level. The presence of HD showed a significant correlation with high Child-Pugh's score, variceal hemorrhage, and HVPG (p = 0.004, 0.002, and 0.019, respectively). In multivariate analysis, Child-Pugh's score (OR 1.43, 95 % CI 1.005-2.038) and HVPG (OR 1.15, 95 % CI 1.003-2.547) had significant relationships with HD. Patients with recent variceal hemorrhages (within 6 months) exhibited significantly higher glucose levels at 120 min in OGTT compared to patients without hemorrhages (p = 0.042). However, there was no difference in fasting glucose levels. The 120-min glucose level and HOMA-IR score were significantly and linearly correlated with HVPG (r 2 = 0.189, p < 0.001 and r 2 = 0.033, p = 0.011, respectively). Conclusion: HD and IR have significant relationships with PHT and variceal hemorrhage. Postprandial hyperglycemia in particular had a significant relationship with variceal hemorrhage.

Original languageEnglish
Pages (from-to)3335-3341
Number of pages7
JournalDigestive diseases and sciences
Volume58
Issue number11
DOIs
Publication statusPublished - 2013 Nov 1

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Portal Pressure
Fibrosis
Venous Pressure
Insulin Resistance
Hemorrhage
Glucose Tolerance Test
Liver
Glucose
Portal Hypertension
Fasting
Homeostasis
Varicose Veins
Serologic Tests
Diabetes Complications
Hyperglycemia
Endoscopy
Diabetes Mellitus
Multivariate Analysis

All Science Journal Classification (ASJC) codes

  • Physiology
  • Gastroenterology

Cite this

Jeon, Hyo Keun ; Kim, Moonyoung ; Baik, Soonkoo ; Park, Hong Jun ; Choi, Hoon ; Park, So Yeon ; Kim, Bo Ra ; Hong, Jin Heon ; Jo, Ki Won ; Shin, Seung Yong ; Kim, Jung Min ; Kim, Jae Woo ; Kim, Hyunsoo ; Kwon, Sang Ok ; Kim, Young Ju ; Cha, Seung Hwan ; Kim, Dong Joon ; Suk, Ki Tae ; Cheon, Gab Jin ; Kim, Young Don ; Choi, Dae Hee ; Lee, Sung Joon. / Hepatogenous diabetes in cirrhosis is related to portal pressure and variceal hemorrhage. In: Digestive diseases and sciences. 2013 ; Vol. 58, No. 11. pp. 3335-3341.
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abstract = "Background and Aim: The clinical impact and complications of hepatogenous diabetes (HD) on cirrhosis have not been elucidated. This study aimed to evaluate the relationship of HD with portal hypertension (PHT) and variceal hemorrhage and to assess the prevalence of HD. Methods: From July 2007 to December 2009, 75-g oral glucose tolerance test and insulin resistance (IR) were evaluated for 195 consecutive cirrhotic liver patients (M:F = 164:1, 53.0 ± 10.2 years) who had no history of diabetes mellitus. IR was calculated using the homeostasis model of assessment-insulin resistance (HOMA-IR) formula. Endoscopy for varices, hepatic venous pressure gradient (HVPG), and serologic tests were also conducted. Results: HD was observed in 55.4 {\%} (108/194) of the patients. Among them, 62.0 {\%} required OGTT for diagnosis because they did not show an abnormal fasting plasma glucose level. The presence of HD showed a significant correlation with high Child-Pugh's score, variceal hemorrhage, and HVPG (p = 0.004, 0.002, and 0.019, respectively). In multivariate analysis, Child-Pugh's score (OR 1.43, 95 {\%} CI 1.005-2.038) and HVPG (OR 1.15, 95 {\%} CI 1.003-2.547) had significant relationships with HD. Patients with recent variceal hemorrhages (within 6 months) exhibited significantly higher glucose levels at 120 min in OGTT compared to patients without hemorrhages (p = 0.042). However, there was no difference in fasting glucose levels. The 120-min glucose level and HOMA-IR score were significantly and linearly correlated with HVPG (r 2 = 0.189, p < 0.001 and r 2 = 0.033, p = 0.011, respectively). Conclusion: HD and IR have significant relationships with PHT and variceal hemorrhage. Postprandial hyperglycemia in particular had a significant relationship with variceal hemorrhage.",
author = "Jeon, {Hyo Keun} and Moonyoung Kim and Soonkoo Baik and Park, {Hong Jun} and Hoon Choi and Park, {So Yeon} and Kim, {Bo Ra} and Hong, {Jin Heon} and Jo, {Ki Won} and Shin, {Seung Yong} and Kim, {Jung Min} and Kim, {Jae Woo} and Hyunsoo Kim and Kwon, {Sang Ok} and Kim, {Young Ju} and Cha, {Seung Hwan} and Kim, {Dong Joon} and Suk, {Ki Tae} and Cheon, {Gab Jin} and Kim, {Young Don} and Choi, {Dae Hee} and Lee, {Sung Joon}",
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Jeon, HK, Kim, M, Baik, S, Park, HJ, Choi, H, Park, SY, Kim, BR, Hong, JH, Jo, KW, Shin, SY, Kim, JM, Kim, JW, Kim, H, Kwon, SO, Kim, YJ, Cha, SH, Kim, DJ, Suk, KT, Cheon, GJ, Kim, YD, Choi, DH & Lee, SJ 2013, 'Hepatogenous diabetes in cirrhosis is related to portal pressure and variceal hemorrhage', Digestive diseases and sciences, vol. 58, no. 11, pp. 3335-3341. https://doi.org/10.1007/s10620-013-2802-y

Hepatogenous diabetes in cirrhosis is related to portal pressure and variceal hemorrhage. / Jeon, Hyo Keun; Kim, Moonyoung; Baik, Soonkoo; Park, Hong Jun; Choi, Hoon; Park, So Yeon; Kim, Bo Ra; Hong, Jin Heon; Jo, Ki Won; Shin, Seung Yong; Kim, Jung Min; Kim, Jae Woo; Kim, Hyunsoo; Kwon, Sang Ok; Kim, Young Ju; Cha, Seung Hwan; Kim, Dong Joon; Suk, Ki Tae; Cheon, Gab Jin; Kim, Young Don; Choi, Dae Hee; Lee, Sung Joon.

In: Digestive diseases and sciences, Vol. 58, No. 11, 01.11.2013, p. 3335-3341.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Hepatogenous diabetes in cirrhosis is related to portal pressure and variceal hemorrhage

AU - Jeon, Hyo Keun

AU - Kim, Moonyoung

AU - Baik, Soonkoo

AU - Park, Hong Jun

AU - Choi, Hoon

AU - Park, So Yeon

AU - Kim, Bo Ra

AU - Hong, Jin Heon

AU - Jo, Ki Won

AU - Shin, Seung Yong

AU - Kim, Jung Min

AU - Kim, Jae Woo

AU - Kim, Hyunsoo

AU - Kwon, Sang Ok

AU - Kim, Young Ju

AU - Cha, Seung Hwan

AU - Kim, Dong Joon

AU - Suk, Ki Tae

AU - Cheon, Gab Jin

AU - Kim, Young Don

AU - Choi, Dae Hee

AU - Lee, Sung Joon

PY - 2013/11/1

Y1 - 2013/11/1

N2 - Background and Aim: The clinical impact and complications of hepatogenous diabetes (HD) on cirrhosis have not been elucidated. This study aimed to evaluate the relationship of HD with portal hypertension (PHT) and variceal hemorrhage and to assess the prevalence of HD. Methods: From July 2007 to December 2009, 75-g oral glucose tolerance test and insulin resistance (IR) were evaluated for 195 consecutive cirrhotic liver patients (M:F = 164:1, 53.0 ± 10.2 years) who had no history of diabetes mellitus. IR was calculated using the homeostasis model of assessment-insulin resistance (HOMA-IR) formula. Endoscopy for varices, hepatic venous pressure gradient (HVPG), and serologic tests were also conducted. Results: HD was observed in 55.4 % (108/194) of the patients. Among them, 62.0 % required OGTT for diagnosis because they did not show an abnormal fasting plasma glucose level. The presence of HD showed a significant correlation with high Child-Pugh's score, variceal hemorrhage, and HVPG (p = 0.004, 0.002, and 0.019, respectively). In multivariate analysis, Child-Pugh's score (OR 1.43, 95 % CI 1.005-2.038) and HVPG (OR 1.15, 95 % CI 1.003-2.547) had significant relationships with HD. Patients with recent variceal hemorrhages (within 6 months) exhibited significantly higher glucose levels at 120 min in OGTT compared to patients without hemorrhages (p = 0.042). However, there was no difference in fasting glucose levels. The 120-min glucose level and HOMA-IR score were significantly and linearly correlated with HVPG (r 2 = 0.189, p < 0.001 and r 2 = 0.033, p = 0.011, respectively). Conclusion: HD and IR have significant relationships with PHT and variceal hemorrhage. Postprandial hyperglycemia in particular had a significant relationship with variceal hemorrhage.

AB - Background and Aim: The clinical impact and complications of hepatogenous diabetes (HD) on cirrhosis have not been elucidated. This study aimed to evaluate the relationship of HD with portal hypertension (PHT) and variceal hemorrhage and to assess the prevalence of HD. Methods: From July 2007 to December 2009, 75-g oral glucose tolerance test and insulin resistance (IR) were evaluated for 195 consecutive cirrhotic liver patients (M:F = 164:1, 53.0 ± 10.2 years) who had no history of diabetes mellitus. IR was calculated using the homeostasis model of assessment-insulin resistance (HOMA-IR) formula. Endoscopy for varices, hepatic venous pressure gradient (HVPG), and serologic tests were also conducted. Results: HD was observed in 55.4 % (108/194) of the patients. Among them, 62.0 % required OGTT for diagnosis because they did not show an abnormal fasting plasma glucose level. The presence of HD showed a significant correlation with high Child-Pugh's score, variceal hemorrhage, and HVPG (p = 0.004, 0.002, and 0.019, respectively). In multivariate analysis, Child-Pugh's score (OR 1.43, 95 % CI 1.005-2.038) and HVPG (OR 1.15, 95 % CI 1.003-2.547) had significant relationships with HD. Patients with recent variceal hemorrhages (within 6 months) exhibited significantly higher glucose levels at 120 min in OGTT compared to patients without hemorrhages (p = 0.042). However, there was no difference in fasting glucose levels. The 120-min glucose level and HOMA-IR score were significantly and linearly correlated with HVPG (r 2 = 0.189, p < 0.001 and r 2 = 0.033, p = 0.011, respectively). Conclusion: HD and IR have significant relationships with PHT and variceal hemorrhage. Postprandial hyperglycemia in particular had a significant relationship with variceal hemorrhage.

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