Prevalence and Risk Factors of Diabetes Mellitus in Patients with Autoimmune Hepatitis

Abstract

Objective The administration of corticosteroids is a standard treatment for autoimmune hepatitis (AIH), but it can occasionally induce various adverse effects. Diabetes mellitus (DM) is a major complication of chronic liver diseases. We investigated the prevalence and risk factors of DM in patients with AIH. Methods We retrospectively analyzed 118 Japanese patients diagnosed with AIH from 1990 to 2014 at our institution. The prognosis of patients with and without DM was also compared. Results Twenty-nine (24.5%) patients had DM and 21 (72.4%) received corticosteroids. The annual cumulative incidence rate of newly diagnosed DM was 1.2%. Multivariate analysis showed that DM occurred in older patients [OR=6.290; 95% confidence interval (CI)=1.230-32.100; p=0.018] with higher serum immunoglobulin G levels (OR=12.400; 95% CI=2.560-60.400; p=0.002). A Cox hazard regression analysis revealed that predictive factors for DM were absence of other autoimmune diseases (OR=0.171; 95% CI=0.036-0.805; p=0.025), use of corticosteroids (OR=6.693; 95% CI=1.391-32.210; p=0.049) and lower platelet counts (OR= 3.873; 95% CI=1.021-14.690; p=0.046). The 10 year survival rates of the DM and non-DM groups were 94.1% and 94.6%, respectively. There was no significant difference between these groups (p=0.293). Conclusion DM occurred in 24.5% of patients with AIH; older age, absence of other autoimmune diseases and higher serum immunoglobulin G levels are risk factors. Taking corticosteroids and a lower platelet count are risk factors for a new onset of DM. DM did not influence the prognosis of AIH patients.

Effects of Silymarin on Diabetes Mellitus Complications: A Review

“…Other complications of diabetes include liver diseases that are mainly caused by insulin resistance and oxidative stress (Bouderba et al ., ). Two hepatic complications are largely present in patients with diabetes: (i) concomitant autoimmune hepatitis (Matsumoto et al ., ) and (ii) NAFLD (Forlani et al ., ). A study of 118 diabetic patients found a prevalence of 24.5% of concomitant autoimmune hepatitis in diabetic patients (Matsumoto et al ., ).…”

“…Two hepatic complications are largely present in patients with diabetes: (i) concomitant autoimmune hepatitis (Matsumoto et al ., ) and (ii) NAFLD (Forlani et al ., ). A study of 118 diabetic patients found a prevalence of 24.5% of concomitant autoimmune hepatitis in diabetic patients (Matsumoto et al ., ). NAFLD is a public health concern, the major treatment for which remains lifestyle changes, including weight reduction, the prevention of weight gain, a healthy diet, and physical activity (Zelber‐Sagi et al ., ).…”

Diabetes Mellitus and Autoimmune Hepatitis: Demographical and Clinical Description of a Relatively Rare Phenotype

“…The prev-▶table 3 Demographical, clinical, and metabolic comparison of patients with T1DM with or without AIH. alence of T3DM in patients with AIH being treated with corticosteroids is unknown [41]. In our analysis of 139 patients with AIH and diabetes, we found 7 patients with T3DM as a consequence of steroid treatment.…”

“…Matsumoto et al analyzed 118 adult patients with AIH and found diabetes in 29 (24.5 %) patients, one of these having T1DM. Twenty-one (72.4 %) of the patients with diabetes received corticosteroids [41]. Otherwise, data on the occurrence of diabetes in patients with AIH undergoing treatment with corticosteroids are lacking.…”

Autoimmune liver diseases and diabetes

“…An association between T2D and AIH may therefore be anticipated. Yoneyama et al [32] found a prevalence of diabetes (type unspecified) of 37·9% in 29 AIH patients receiving corticosteroids, and Matsumoto et al [33] found a prevalence of diabetes (primarily T2D) of 24·5% in 118 AIH patients, 72·4% of whom receiving corticosteroids. Corticosteroids and a lower platelet count were associated with the new onset of diabetes, and patients with AIH and diabetes were significantly older, had a higher proportion of male sex, were less likely to have other autoimmune diseases, had lower platelet count, and had higher IgG levels than did patients with AIH without diabetes.…”