Nisan 2012
4 yillik kronik karaciger hastalikli olgularimizda diyabetes mellitus ile birlikteligin degerlendirilmesi
Four-year evaluation and association between chronic liver disease and diabetes mellitus in a patient
- Ana Sayfa
- Sayılar
- Nisan 2012
- 4 yillik kronik karaciger hastalikli olgularimizda diyabetes mellitus ile birlikteligin degerlendirilmesi...
Özet
Amaç: Kronik karaciger hastaliklarinda glikoz metabolizma bozukluklari ve diyabetes mellitus sikligi artmistir. Diyabet, karaciger sirozu olan hastalarin morbidite ve mortalitesini artirmaktadir. Çalismamizin amaci, kronik karaciger hastaliginda (kronik hepatit, karaciger sirozu ve hepatosellüler kanser) diyabetes mellitus görülme sikligi ile karaciger hastaligi etiyolojisi ve siddeti arasindaki iliskinin degerlendirilmesidir. Gereç ve Yöntem: Yüz seksen alti kronik karaciger hastasi (90 kronik hepatit, 80 siroz ve 16 hepatosellüler kanser) retrospektif olarak çalismaya dahil edilmistir. Hastalarin açlik kan sekerleri degerlendirilerek, normoglisemi, bozulmus açlik glikozu ve diyabetes mellitus durumlari saptanmistir. Hastalar yas, cinsiyet, etyoloji (HBV, HCV, alkol ve kriptojenik) ve hastalik grubuna (kronik hepatit, karaciger sirozu, hepatosellüler kanser) göre, sirozu ve hepatosellüler kanser tanisi olan olgular ise ayrica Child-Pugh ve MELD (Model for End-Stage Liver Disease) skoruna göre gruplandirilarak degerlendirilmistir. Sonuçlar: Kronik karaciger hastalarinda diyabet ve bozulmus açlik glikozu sikliklari sirasiyla %28 ve %20.4 oldugu görüldü. Sirozlu olgularda diyabetes mellitus ve bozulmus açlik glikozu sikligi kronik hepatitlilere göre anlamli olarak yüksek bulundu (p=0.004). Child A, B, C ve MELD skorunun 14 ve alti ile 15 ve üstü seklinde gruplandirilan olgularin normoglisemi, bozulmus açlik glikozu ve diyabetes mellitus dagilimlarinda istatistiksel bir fark saptanmadi (p:0.781, p=0.423). Kriptojenik (%67.7), HCV (%56.8) ve alkole bag- li karaciger hastalarinda (%60), HBV?li (%38.9) olgulara göre daha yüksek oranda bozulmus açlik glikozu ve diyabetes mellitus saptandi (p=0.017). Tartisma: Kronik karaciger hastalarinda diyabetin erken tani ve tedavisiyle morbidite ve mortalitenin azalmasi beklenebilir.
Abstract
Background and Aims: Diabetes mellitus increases morbidity and mortality in patients with liver cirrhosis. The aim of this study was to investigate the rate of diabetes mellitus in chronic liver diseases (chronic hepatitis, liver cirrhosis and hepatocellular cancer) and to evaluate the correlation of diabetes mellituswith the etiology and severity of liver disease. Materials and Methods: One hundred and eighty-six patients withchronic liver disease (90 chronic hepatitis, 80 cirrhosis and 16 hepatocellular carcinoma) were recruited retrospectively from January 2007 to July 2010. Based on fasting blood glucose levels, normoglycemia, impaired fasting glucose, and diabetes mellitusstates among patients were determined. Patients were evaluated by classification in terms of age, gender, and etiology, and with a diagnosis of cirrhosis and hepatocellular cancer, were additionally classified in terms of Child-Pugh and MELD (Model for End-Stage Liver Disease) scores. Results: Rates of diabetes mellitusand impaired fasting glucose among chronic liver disease patients were determined as 28% and 20.4%, respectively. Normoglycemia was significantly higher in HBV patients than in HCV, alcohol-induced chronic liver disease and cryptogenic patients (p<0.05). Impaired fasting glucose was significantly higher in alcohol-induced chronic liver disease patients than in HBV, HCV and cryptogenic patients (p<0.05). Diabetes mellitus was significantly higher in HCV and cryptogenic patients than in HBV and alcohol-induced chronic liver disease patients (p<0.05). impaired fasting glucose + diabetes mellituswere significantly lower in HBV patients than in HCV, alcohol-induced chronic liver disease and cryptogenic patients (p<0.05). Conclusions: With early diagnosis and treatment of diabetes mellitus in patients with chronic liver diseases, a decrease in morbidity and mortality may be expected.
