Low incidence of vascular complications in patients with diabetes mellitus associated with liver cirrhosis as compared with type 2 diabetes mellitus
Low incidence of vascular complications in patients with diabetes mellitus associated with liver cirrhosis as compared with type 2 diabetes mellitus
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DOI：
10.1620/tjem.205.327
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发表时间：
2005-04-01
影响因子：
2.2
通讯作者：
Satoh, J
中科院分区：
文献类型：
--
作者：
Fujiwara, F;Ishii, M;Satoh, J
我们比较了合并肝硬化的糖尿病患者与 2 型糖尿病患者的临床特征和血管并发症。受试者为 19 名在肝硬化后被诊断为糖尿病的患者（LC-DM 组）。对照组由 38 名 2 型糖尿病患者（T2DM 组）组成，其性别、年龄、糖尿病病程、体重指数、治疗和血糖控制程度（由糖白蛋白确定）相匹配。与 T2DM 组相比，LC-DM 组的吸烟者明显较多，血清胰岛素水平较高，通过稳态模型评估计算出的胰岛素抵抗较多，血细胞计数（白细胞和红细胞、血红蛋白和血小板）较低，血清总胆固醇、甘油三酯、低密度脂蛋白胆固醇和脂蛋白 (Lp)(a) 水平较低。与T2DM组相比，LC-DM组糖尿病视网膜病变和脑血管疾病的发生率显着降低。 Logistic回归分析表明，Lp(a)和糖尿病病程是视网膜病变的显着预测因子，而Lp(a)是脑血管并发症的显着预测因子。在本研究中，与肝硬化相关的糖尿病中，糖尿病视网膜病变和脑血管疾病的发生率低于2型糖尿病，可能是因为血清Lp(a)水平较低。
We compared clinical features and vascular complications of patients with diabetes mellitus associated with liver cirrhosis versus patients with type 2 diabetes mellitus. Subjects were 19 patients (LC-DM group) in whom diabetes was diagnosed after development of liver cirrhosis. Control consisted of 38 patients with type 2 diabetes (T2DM group) matched for sex, age, duration of diabetes, body mass index, treatment, and degree of glycemic control, which was determined by glycoalbumin. The LC-DM group had significantly more smokers, higher serum insulin levels, more insulin resistance calculated by homeostasis model assessment, lower blood counts (white and red blood cells, hemoglobin, and platelets), and lower serum levels of total cholesterol, triglyceride, low density lipoprotein cholesterol and lipoprotein (Lp)(a) than the T2DM group. The incidence of diabetic retinopathy and cerebrovascular disease was significantly lower in the LC-DM group compared to the T2DM group. Logistic regression analysis indicated that Lp(a) and the diabetes duration were significant predictors for the retinopathy, while Lp(a) was a significant predictor for the cerebrovascular complication. In diabetes associated with liver cirrhosis, the incidence of diabetic retinopathy and cerebrovascular disease is lower than in type 2 diabetes mellitus in this study, probably because of lower levels of serum Lp(a).