Incidence of insulin resistance and diabetes in patients with portosystemic shunts without liver dysfunction

Abstract

ObjectiveTo investigate the incidence of insulin resistance (IR) and diabetes in patients with chronic hepatic schistosomiasis japonica (HSJ) and portosystemic shunts (PSS).MethodsPre- and post-contrasted computed tomography images obtained from patients with HSJ and control subjects were reviewed by two radiologists who identified and graded any shunting vessels. Anthropometric measurements, hepatic enzymes, lipid profile, blood levels of albumin, glucose, insulin and homeostasis model assessment (HOMA-2) index of all participants were also assessed.ResultsFifty-two patients with HSJ and 30 control subjects were involved in the study. The coronary, short gastric and perisplenic veins were the most common shunting vessels. There were no significant differences between patients and controls in terms of body mass index or liver function. The degree of shunting vessels, blood glucose, oral glucose tolerance test120/0, insulin, HOMA-2 index, glycosylated haemoglobin, cholesterol, high- and low-density lipoprotein, and C-reactive protein were significantly higher in the patients with IR. A positive correlation was found between the degree of the shunting vessels and the HOMA-2 index.ConclusionsPatients with chronic HSJ and PSS without liver dysfunction had a high incidence of IR and diabetes. The study showed that PSS and IR are related and therefore patients with PSS should be screened for IR and vice versa.

The Effects of Folate Supplementation on Diabetes Biomarkers Among Patients with Metabolic Diseases: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

“…Hyperinsulinemia and insulin resistance are common in patients with metabolic disorders, including type 2 diabetes mellitus (T2DM) [1], metabolic syndrome (MetS) [2], polycystic ovary syndrome (PCOS) [3], and cardiovascular disease (CVD) [4]. Poor glycemic control would result in long-term adverse outcomes in subjects with T2DM, such as micro-and macrovascular complications, including cardiovascular events, renal failure, blindness, and peripheral neuropathy [5].…”

Magnetic Resonance Spectroscopy for Evaluating Portal-Systemic Encephalopathy in Patients with Chronic Hepatic Schistosomiasis Japonicum

“…Usually, chronic HSJ patients lack objective physical findings such as gynecomastia and vascular spider, and abnormal liver function tests, which are frequently found in cirrhotic patients [1, 2]. However, hyper intensity in bilateral Globus pallidus on T1WI and portal-systemic shunting vessels could be detected by brain MRI and abdominal CT, respectively [5, 12]. Most of the patients develop neurological abnormalities (overt PSE) in the later stage of chronic hepatic schistosomiasis.…”

“…Chronic HSJ was diagnosed on the basis of a history of schistosomiasis and typical liver CT (linear hyper dense calcifications) or ultrasonic findings (linear strong echoes) [11]. The diagnosis of portal-systemic shunting was based on abdominal CT scanning for abnormal shunting vessels [12]. Thirteen shunting vessels were identified, namely, coronary, gastroepiploic, esophageal, para-esophageal, short gastric, peri splenic, splenorenal, gastrorenal, paraumbilical, abdominal wall vein, retroperitoneal-paravertebral, mesenteric, and omental vessels.…”

Prediction of minimal hepatic encephalopathy by using an radiomics nomogram in chronic hepatic schistosomiasis patients

“…CHS is characterized by progressive liver fibrosis, portal hypertension and portal-systemic shunting [ 18 ]. However, no or mild biochemical evidences of liver dysfunction are showed in compensatory stage CHS patients [ 19 , 20 ]. MHE causing by CHS remains neglected until the patients develop into OHE, upper gastrointestinal bleeding, hepatorenal syndrome or hepatopulmonary syndrome in the late stage of CHS [ 21 , 22 ].…”