Prevalence of diabetes in liver cirrhosis: A systematic review and meta‐analysis

Abstract

An association between diabetes mellitus (DM) and liver cirrhosis is well‐known, but estimates of the prevalence of DM in patients with liver cirrhosis vary widely. A systematic review was undertaken to determine the prevalence of DM in adult patients with liver cirrhosis. The Medline, EMBASE, and Cochrane Library databases were searched for peer‐reviewed studies published in English (1979‐2017) that investigated the prevalence of diabetes in adult patients with cirrhosis. Pooled estimates of prevalence of DM were determined for all eligible patients and according to aetiology and severity of liver disease. Fifty‐eight studies satisfied criteria for inclusion, with 9705 patients included in the pooled prevalence analysis. The overall prevalence of DM was 31%. The prevalence of DM was highest in patients with nonalcoholic fatty liver disease (56%), cryptogenic (51%), hepatitis C (32%), or alcoholic (27%) cirrhosis. For assessing prevalence of DM as a function of severity of liver disease, evaluable data were available only for hepatitis C and hepatitis B cirrhosis. DM may be more prevalent in cirrhosis than previously thought. This has implications for prognosis and treatment in these patients.

Association between Different Hepatitis C Virus Genotypes Infection and Type-2 Diabetes Mellitus: A Descriptive-Analytical Study from the Northwest of Iran

“…In the current study, T2DM proved to be a risk factor associated with cirrhosis in HCV patients; T2DM as a risk factor for cirrhosis in other health conditions such as metabolic syndrome, cryptogenic cirrhosis, and nonalcoholic steatohepatitis was already proven [28][29][30][31][32]. The primary pathophysiologic process proposed to intervene in this relationship between T2DM and cirrhosis is that T2DM accelerates hepatocyte destruction, leading to increased liver function tests [33].…”

Prevalence of Diabetes Mellitus among Hepatitis B Infected Patients Attending Communicable Disease Research and Training Center, Suez City, Egypt

“…To assess the prevalence of DM as a function of liver disease severity, the assessable data was only available for hepatitis C and hepatitis B cirrhosis. DM may be more prevalent in cirrhosis than previously thought (26) . Infection with HBV is associated with significant risks for health.…”

Interleukin-6-174G/C polymorphism is associated with a decreased risk of type 2 diabetes in patients with chronic hepatitis C virus

“…Hence, cirrhosis per se might lead to glucose intolerance or diabetes mellitus. The prevalence of diabetes in cirrhotic patients with non-alcoholic fatty liver disease, cryptogenic, hepatitis C, and alcoholic hepatopathy ranges from 27.3% to 56.1%[ 13 ]. Regarding the HCV and the non-alcoholic fatty hepatic disease we have to bear in mind that type 2 diabetes mellitus can be detected prior to the onset of hepatic cirrhosis[ 13 - 15 ] promoting a vicious cycle of hyperglycaemia causing a worsening metabolic state.…”

“…The prevalence of diabetes in cirrhotic patients with non-alcoholic fatty liver disease, cryptogenic, hepatitis C, and alcoholic hepatopathy ranges from 27.3% to 56.1%[ 13 ]. Regarding the HCV and the non-alcoholic fatty hepatic disease we have to bear in mind that type 2 diabetes mellitus can be detected prior to the onset of hepatic cirrhosis[ 13 - 15 ] promoting a vicious cycle of hyperglycaemia causing a worsening metabolic state. Thus, altogether, glucose disturbed metabolism and HCV enhance the chronic inflammation and might interact as a reciprocal feed-forward loop[ 16 - 19 ].…”