Relationship between pancreatic beta cell function and liver function in hepatitis B cirrhosis / 中国基层医药

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(2hPG),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 (HbA1c),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)mmot/L,(5.68 ±2.81) mmol/L,(9.82 ±5.1) mmol/L],HbA1c [(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,HbA1c 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) mU/L,(26.53 ± 7.22) mU/L,(30.18 ± 3.23) mU/L],postprandial insulin [(45.28 ± 10.22) mU/L,(106.8 ± 20.74) mU/L,(141.68 ±20.25) mU/L],postprandial C peptide [(5.96 ± 4.82) mU/L,(9.86 ± 5.46) mU/L,(9.54 ± 6.42) mU/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 (x2 =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.