Prognosis analysis of hepatitis B cirrhosis patients with type 2 diabetes mellitus

Abstract

Objective To investigate the impact of type 2 diabetes mellitus (DM) on the progression and prognosis of patients with hepatitis B cirrhosis. Methods A total of 247 hospitalized patients with hepatitis B cirrhosis in Child A and B phases were collected from January 2008 to March 2009 in 9th Hospital of Nanchang. Based on type 2 DM diagnosis, the hepatitis B cirrhosis patients were divided into non-DM group (n=168) and DM group (n=79). Occurrence and survival rate of hepatic decompensation, cirrhosis complications, cardiovascular disease and hepatocellular carcinoma were retrospective analyzed. Comparative t-test was used for measurement data, χ2 test was used for count data and Log-rank test was used for survival rate. Multivariate analysis was conducted by Logistic regression. Results In DM group, 68 cases (86.1%) developed hepatic decompensation, 63 cases (79.7%) of cirrhosis complications, 11 cases (13.9%) of cardiovascular diseases and 19 cases (24.1%) of hepatocellular carcinoma, which were all higher than those in non-DM group (118 cases [70.2%] of hepatic decompensation [χ2=5.930, P=0.015]; 106 cases [63.1%] of cirrhosis complications [χ2=6.895, P=0.009]; only 1 case [0.6%] of cardiovascular disease [χ2=20.652, P=0.000]; and 18 cases [10.7%] of hepatocellular carcinoma [χ2=7.504, P=0.006]). The differences were all statistically significant. Survival rates for 2-year, 4-year and 6-year follow-up in DM group were all obviously lower than those of non-DM group (86.1% vs 96.3%, 56.5% vs 77.5%, 17.4% vs 39.2%, respectively), and the difference was statistically significant (χ2=14.208, P=0.000). The mortalities of cirrhosis complication (36.7% vs 21.4%; χ2=6.470, P=0.011) and hepatocellular carcinoma (12.7% vs 3.6%; χ2=7.324, P=0.007) in DM group were both significantly higher than those in non-DM group. After adjusting for sex, age, alcohol use and Child score, DM remained an independent predictor for hepatocellular carcinoma (odds ratio=3.232, 95% confidence interval: 1.378-7.580; P=0.007). Conclusion Type 2 DM could increase the incidences of hepatic decompensations, cirrhosis complications, hepatocellular carcinoma and cardiovascular diseases, while reduce the survival rate of patients with cirrhosis, which has an serious impact on the prognosis of hepatitis B cirrhosis patients. Key words: Hepatitis B; Liver cirrhosis; Diabetes mellitus, type 2; Prognosis