Therapeutic effects of entecavir and adefovir dipivoxil in hepatitis B cirrhosis patients with hepatogenous diabetes: a comparative analysis / 临床肝胆病杂志

ABSTRACT

ObjectiveTo investigate the therapeutic effect of entecavir or adefovir dipivoxil as the antiviral therapy for hepatitis B cirrhosis patients with hepatogenous diabetes. MethodsA total of 80 hepatitis B cirrhosis patients with hepatogenous diabetes who visited Qingdao Hospital of Infectious Diseases were enrolled, and according to the antiviral drug they chose, they were divided into group A and group B, with 40 patients in each group. The patients in group A were treated with oral administration of entecavir 0.5 mg qd, and those in group B were treated with oral administration of adefovir dipivoxil 10 mg qd. The antiviral therapy lasted for 48 weeks. The patients in both groups were given diabetic diets and insulin to control blood glucose, as well as liver-protecting and transaminase-lowering treatments. The changes in biochemical parameters, viral response, diabetes control, and the improvement in liver stiffness after treatment were observed in both groups. The t-test was used for comparison of continuous data between groups, and the chi-square test was used for comparison of categorical data between groups. ResultsThe viral response showed a significant difference between group A (85%, 34/40) and group B (65%, 26/40) (χ2=4.27, P＜0.05). Compared with group B, group A showed significant improvements in biochemical parameters (P＜0.05). After 48 weeks of treatment, group A had significantly lower levels of blood glucose and glycosylated hemoglobin than group B (blood glucose: 7.53±1.13 mmol/L vs 8.34±1.12 mmol/L, t=3.220, P＜0.05; glycosylated hemoglobin: 7.23%±0.64% vs 7.79%±084%, t=3.354; P＜0.05). After the treatment, liver stiffness showed a significant difference between group A and group B (16.86±5.67 kPa vs 19.47±5.32 kPa, t=2.123, P＜0.05). ConclusionCompared with adefovir dipivoxil, entecavir can improve glycogen metabolism and blood glucose regulation through improving liver function and promoting hepatocyte repair, and finally achieve a better blood glucose control.