Abstract
Background and AimTo investigate the short-term dynamic changes and the factors associated with regression of glucose metabolism disorders in patients with hepatitis flare of chronic hepatitis B virus (HBV) infection.MethodsIn this study, 118 patients with severe hepatitis flare of chronic HBV infection were prospectively studied. Oral glucose tolerance test was performed on admission and during follow-up to evaluate dynamic changes in glucose metabolism disorders. The factors associated with regression of glucose metabolism disorders were identified using univariate and multivariate logistic regression analyses.ResultsThe prevalence of diabetes was significantly higher in 70 (47.1%) patients with liver cirrhosis than that in 48 (16.8%) patients without liver cirrhosis. The prevalence of impaired glucose tolerance in patients with liver cirrhosis (35.7%) was significantly lower than that in patients without liver cirrhosis (47.8%). After a follow-up of 20.0 ± 18.7 days, 28 of 31 (90.3%) patients without liver cirrhosis experienced regression of glucose metabolism disorders. Additionally, 30 (54.5%) patients with liver cirrhosis experienced regression of glucose metabolism disorders after 42.0 ± 36.2 days. In patients with liver cirrhosis, those with regression of glucose metabolism disorders had significantly higher levels of homeostasis model assessment-β-cell function, albumin (ALB), and a significantly lower level of fibrosis-4 score. ALB was identified as an independent factor associated with the regression of glucose metabolism disorders in patients with liver cirrhosis.ConclusionSevere acute liver inflammation aggravates glucose metabolism disorders in patients with hepatitis B-related liver cirrhosis and high ALB level is associated with regression of glucose metabolism disorders upon resolution of acute liver inflammation.
Highlights
Glucose metabolism is altered in patients with various acute and chronic diseases, resulting in hypoglycemia, impaired glucose tolerance (IGT), or diabetes (Hamed et al, 2019)
Diabetes is associated with poor long-term prognosis and high risk of complications, such as bacterial infection, bleeding esophageal varices, hepatic encephalopathy, and hepatocellular carcinoma, in patients with liver cirrhosis (Sigal et al, 2006; Konishi et al, 2009; Erice et al, 2012; Jeon et al, 2013; Elkrief et al, 2014). These findings suggest the necessity of long-term management of glucose metabolism disorders in patients with liver cirrhosis
The major findings of this study are that the severe hepatitis flare mostly resulted in IGT in patients without liver cirrhosis, whereas it mostly resulted in diabetes in patients with liver cirrhosis
Summary
Glucose metabolism is altered in patients with various acute and chronic diseases, resulting in hypoglycemia, impaired glucose tolerance (IGT), or diabetes (Hamed et al, 2019). Diabetes secondary to severe impairment of liver function is recognized as hepatogenous diabetes (HD); it is not classified as an independent disease by the World Health Organization (Orsi et al, 2016). The etiology and severity of liver cirrhosis are associated with the development of HD. Hyperglycemia has been found in patients with acute hepatitis and acute liver failure, suggesting that acute liver injury may contribute to the development of glucose metabolism disorders in patients with liver diseases. To investigate the short-term dynamic changes and the factors associated with regression of glucose metabolism disorders in patients with hepatitis flare of chronic hepatitis B virus (HBV) infection
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