RE: Re: psc complications/diabetes

[Guest guest]

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I have had the same questions as Phil. Is

there a higher prevalence of diabetes among PSC'ers?

I found this Feb 2000 study

from Mayo –

J Hepatol. 2000 Feb;32(2):209-17.

Prevalence of diabetes mellitus in patients with end-stage liver cirrhosis

due to hepatitis C, alcohol, or cholestatic disease.

Zein NN, Abdulkarim AS, Wiesner RH, Egan KS, Persing DH.

Division of Gastroenterology, Hepatology & Internal Medicine, Mayo Clinic Rochester, Minnesota

BACKGROUND/AIMS: The aims were

to study: 1) the prevalence of diabetes mellitus in patients with end-stage

liver cirrhosis due to hepatitis C, alcohol, or cholestatic liver disease, 2) viral and host immunogenetic factors that may

predispose to diabetes, and 3) liver transplantation outcome in patients with

or without diabetes.

METHODS: Fasting blood glucose values of patients who underwent liver

transplantation because of hepatitis C-related cirrhosis (73 patients) were

compared with those of patients with cirrhosis due to cholestatic (78 patients)

or alcoholic liver disease (53 patients) and to a general population. Data on diabetes prevalence in a population without liver

cirrhosis was based on the prevalence of diabetes in Olmsted

County, Minnesota, residents. HLA was determined using serologic assays. Hepatitis C virus genotypes were determined with

polymerase chain reaction amplification and direct sequencing.

Hepatitis G RNA was detected with polymerase chain reaction. Liver transplantation outcome in patients with or without

diabetes was determined with rejection, retransplantation, or death at 1 year

after transplantation as end points.

RESULTS: Of 64

patients with hepatitis C alone, 16 (25%) had diabetes before transplantation

compared with 1 of 78 (1.3%) with cholestatic liver disease

(p= 0.0001) and 10 of 53 (19%) with alcoholic liver disease (p=0.36). Nine patients had hepatitis C plus cholestatic liver

disease; one of these (11%) had diabetes. The prevalence of diabetes in

patients with cholestatic liver cirrhosis was not different from that of the general

population. The frequency of

hepatitis G virus coinfection, HLA-DR3, or HLA-DR4 in hepatitis C and diabetes

was not different from that of hepatitis C alone. The

distribution of hepatitis C virus genotype was similar in those with and those

without diabetes. Diabetes was not associated with increased risk of rejection,

retransplantation, or death at 1 year after transplantation, and had no impact

on overall survival after transplantation.

CONCLUSIONS: 1) The risk of diabetes is not increased in patients with liver cirrhosis

due to cholestatic liver disease but is in patients with

liver cirrhosis due to hepatitis C or alcoholic liver disease; 2) cofactors

(age, sex, body mass index, hepatitis G virus coinfection, hepatitis C virus

genotype, or HLA-DR3/DR4) did not explain the increased risk of diabetes in

patients with hepatitis C; 3) diabetes before liver transplantation did not change the outcome at 1

year after transplantation or survival.

Publication Types: Research

Support, Non-U.S. Gov't PMID: 10707860 [PubMed -

indexed for MEDLINE]

Barb in Texas - Together in the Fight, Whatever it Takes!

Son Ken (32) UC 91 - PSC 99 Listed 7/21 @ Baylor Dallas