Relationship between pancreatic beta cell function and liver function in hepatitis B cirrhosis

Abstract

Objective To investigate the relationship between pancreatic beta cell function and liver function in hepatitis B cirrhosis with different glucose metabolism status. Methods A total of 247 patients with hepatitis B cirrhosis were included and divided into 3 groups according to measurement of fasting blood glucose(FBG),and 2h blood glucose in 75g oral glucose tolerance test(2h PG),normal glucose metabolic status group(group A,n= 47),glucose tolerance impairment group(group B,n= 103) and diabetes mellitus group(group C,n= 97).Data of fasting and 2h postprandial blood glucose,C-peptide,insulin and glycosylated hemoglobin(Hb A1c),pancreatic beta cell function index(HBCI),insulin sensitivity index(ISI), hepatitis B virus load were collected and analyzed.〛 Results Abnormal glucose metabolism was observed in 81% patients with hepatitis B cirrhosis,while hepatogenic diabetes accounted for 39.3%.2 hPG[(6.29±3.78)mmol/L,(10.56±4.26)mmol/L,(17.34±5.9)mmol/L],FBG[(4.72±2.15)mmol/L,(5.68±2.81) mmol/L,(9.82±5.1)mmol/L],Hb A1c[(4.5±1.2)%(10.56±4.26)%(9.5±3.0)%],HBV-DNA [(3.78±0.52),(4.82±0.61),(6.02±0.63)] were compared in group A,group B and C.2hPG,FBG, Hb A1c and HBV viral loads in group A were significantly lower than group B and group C(F= 93.23,41.35,84.93,237.2,P< 0.05).Fasting insulin[(15.65±4.17)m U/L,(26.53±7.22)m U/L,(30.18±3.23) m U/L],postprandial insulin[(45.28±10.22)m U/L,(106.8±20.74)m U/L,(141.68±20.25)m U/L], postprandial C peptide[(5.96±4.82)m U/L,(9.86±5.46)m U/L,(9.54±6.42)m U/L]and ISI[(-5.96± 0.61),(-4.92±0.42),(-5.03±0.51)]were compared in group C,group B and A,those values in group C were lower than group A and B,the defferences were stastistically significant(P< 0.05).HBCI in three groups were(5.66±0.64),(5.32±1.01),(4.30±1.53),respectively,the defferences were stastistically significant(F= 27.55,P< 0.05).Patients in group C with Child-Pugh C score was much more than group A and B,the defference was stastistically significant(χ2= 48.6,P< 0.01). Conclusion Hyperinsulinemia,increased insulin resistance and decreased insulin secretion exist in hepatitis B cirrhosis patients,and they are closely related to liver function. Key words: Hepatitis B; Liver cirrhosis; Liver function tests; Glucose metabolism disorders; Insulin resistance; Insulin-secreting cells