Hepatogenous Diabetes in Cirrhosis Is Related to Portal Pressure and Variceal Hemorrhage

Jeon, Hyo Keun; Kim, Moon Young; Baik, Soon Koo; Park, Hong Jun; Choi, Hoon Young; Park, So Yeon; Kim, Bo Ra; Hong, Jin Sung; Jo, Ki Won; Shin, Seung Yong; Kim, Jung Min; Kim, Jae Woo; Kim, Hyun Soo; Kwon, Sang Ok; Kim, Young Ju; Hwan, Seung; Kim, Dong Joon; Suk, Ki Tae; Cheon, Gab Jin; Kim, Young Don; Choi, Dong‐Young; Lee, Sung Joon

doi:10.1007/s10620-013-2802-y

Cited by 34 publications

(31 citation statements)

References 27 publications

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“…Actually, investigators have suggested the limited linkage between portal pressure and IR. One theory is that a correlation between HOMA2-IR and HVPG was lost when only patients with clinically significant portal hypertension (HVPG > 10 mmHg) were considered 26, and the other suggestion is that high IR is related to high portal pressure though no correlation was found between IR (HOMA) and HVPG 27. A possible explanation may be a presence of spontaneous shunt formation, which diverts portal blood flow away from the liver, resulting in the reduction of portal pressure 28, and therefore may enhance the importance of the evaluation of physiological portal haemodynamics for the identification of potential IR and of the identification of collateral flow volume > 165 mL/min.…”

Section: Discussionmentioning

confidence: 99%

Interrelationship between insulin resistance and portal haemodynamic abnormality in cirrhosis

Maruyama¹,

Kobayashi²,

Kiyono³

et al. 2017

Int. J. Med. Sci.

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Background: There are only limited data regarding the effect of impaired portal circulation on the glucose metabolism. The study prospectively examined the interrelationship between insulin resistance (IR) and portal haemodynamic abnormality in cirrhosis.Methods: There were 53 cirrhosis patients (61.6 ± 13.0 years) all presenting gastroesophageal varices. Portal haemodynamics by both hepatic venous catheterisation and Doppler ultrasound were examined with respect to the homeostasis model assessment (HOMA)-IR and HOMA2-IR. The IR was defined by HOMA-IR > 3.0 or HOMA2-IR > 2.0.Results: Forty-two patients (79.2%) had collateral vessels, 38 with left gastric vein, 12 with short/posterior gastric vein, 9 with splenorenal shunt, and 3 with inferior mesenteric vein. Multivariate analysis provided significant factors; wedged hepatic venous pressure (HR1.183, 95% CI 1.012-1.383, p=0.035) for HOMA-IR > 3.0, body mass index for HOMA2-IR > 2.0 (HR1.490, 95% CI 1.176-1.888, p=0.001), and collateral flow volume for both HOMA-IR > 3.0 (HR1.007, 95% CI 1.001-1.014, p=0.015) and HOMA2-IR > 2.0 (HR 1.007, 95% CI 1.002-1.013, p=0.009). The best cut-off value of collateral flow volume was 165 ml/min for detecting the HOMA-IR > 3.0 showing area under the receiver operating characteristic curve (AUROC) 0.688 (Odds ratio, 5.33) with sensitivity 70% and specificity 69.6%, and was 165 ml/min for detecting median value of HOMA2-IR > 2.0 showing AUROC 0.698 (odds ratio, 5.7) with sensitivity 75% and specificity 65.5%.Conclusion: There is a close linkage between the IR and impaired portal haemodynamics presented by the collateral development, suggesting the underlying pathogenesis of portal hypertension in cirrhosis patients.

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Section: Discussionmentioning

confidence: 99%

Interrelationship between insulin resistance and portal haemodynamic abnormality in cirrhosis

Maruyama¹,

Kobayashi²,

Kiyono³

et al. 2017

Int. J. Med. Sci.

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“…13 More recent single-centre surveys using current criteria for DM diagnosis 2 have shown that, based on fasting plasma glucose (FPG) levels, alone or associated with measurements of haemoglobin (Hb) A 1c , prevalence of DM in cirrhotic individuals is approximately 30%-40% (Table 1). In particular, Holstein et al 14 Jeon et al 17 of 34.4%. In addition, three studies in cirrhotic patients on the waiting list for OLT (including two surveys from our group) reported prevalence values of 41.7%, 18 27.2%, 19 and 30.7%, 20 respectively, for overt DM, and 16.6%, 18 3.4%, 19 and 10.3%, 20 respectively, for IFG.…”

Section: Epidemiologymentioning

confidence: 97%

“…Presence of DM was also shown to be associated with hepatic encephalopathy, possibly due to multiple mechanisms, as well as with acute liver failure . In addition, incidence rates of ascites, gastrointestinal haemorrhage, bacterial infections, and peritonitis were higher in diabetic than in non‐diabetic cirrhotic individuals. Finally, a large body of evidence indicates that risk of HCC is higher in cirrhotic subjects with DM than in those without …”

Section: Clinical Featuresmentioning

confidence: 98%

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Hepatogenous diabetes: Is it time to separate it from type 2 diabetes?

Orsi

Grancini

Menini

et al. 2016

Liver International

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By definition, hepatogenous diabetes is directly caused by loss of liver function, implying that it develops after cirrhosis onset. Therefore, it should be distinguished from type 2 diabetes developing before cirrhosis onset, in which specific causes of liver disease play a major role, in addition to traditional risk factors. Currently, although hepatogenous diabetes shows distinct pathophysiological and clinical features, it is not considered as an autonomous entity. Recent evidence suggests that the failing liver exerts an independent "toxic" effect on pancreatic islets resulting in β-cell dysfunction. Moreover, patients with hepatogenous diabetes usually present with normal fasting glucose and haemoglobin A levels and abnormal response to an oral glucose tolerance test, which is therefore required for diagnosis. This article discusses the need to separate hepatogenous diabetes from type 2 diabetes occurring in subjects with chronic liver disease and to identify individuals suffering from this condition for prognostic and therapeutic purposes.

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“…이뤄지고 있으며 (12)(13)(14)(15)(16)(17) Lactobacillus curvatus isolated from Kimchi; 2) Weissella viridescens isolated from Kimchi; 3) Lactobacillus plantarum isolated from Kimchi; 4) Leuconostoc lactis isolated from Kimchi; 5) Lactobacillus acidophilus isolated from Kimchi; 6) Lactobacillus sakei subsp. isolated from salt-fermented shrimp;…”

mentioning

confidence: 99%

Antibacterial activity of lactic acid bacteria isolated from traditional fermented foods and development of a starter for fermented milk

Park¹,

Moon²,

Oh³

et al. 2013

Korean Journal of Food Preservation

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This study was conducted to investigate the antibacterial activity of lactic acid bacteria isolated from traditional fermented foods and to develop a new starter for fermented milk. The isolates were identified using 16S rDNA sequencing and named Lactobacillus plantarum A, Leuconostoc lactis B and L. acidophilus C. The activity of these strains to inhibit the growth of food-borne human pathogens (Escherichia coli NCTC 12923, Salmonella Typhimurium NCTC 12023, Listeria monocytogenes NCTC 11994) was measured using the paper disc method. All these strains showed strong antibacterial activity against Li. monocytogenes NCTC 11994. The experiment groups were the fermented milks with these strains, and the control group was the fermented milk with the commercial starter (ABT 5). The change of pH, acidity and viable cell counts were measured during their aging time. All the experiment groups showed a significant difference in their aging times compared to the control group. However, the sensory test showed that the experiment groups can be used as useful starters for fermented milk. This result suggests that L. plantarum A, Leu. lactis B and L. acidophilus C have the potential to be developed as new starters for fermented milk.

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Hepatogenous Diabetes in Cirrhosis Is Related to Portal Pressure and Variceal Hemorrhage

Abstract: HD and IR have significant relationships with PHT and variceal hemorrhage. Postprandial hyperglycemia in particular had a significant relationship with variceal hemorrhage.

Cited by 34 publications

References 27 publications

Interrelationship between insulin resistance and portal haemodynamic abnormality in cirrhosis

Interrelationship between insulin resistance and portal haemodynamic abnormality in cirrhosis

Hepatogenous diabetes: Is it time to separate it from type 2 diabetes?

Antibacterial activity of lactic acid bacteria isolated from traditional fermented foods and development of a starter for fermented milk

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