Investigation of the pathogenesis of hepatogenic diabetes / 中国医师进修杂志

ABSTRACT

Objective To investigate the pathogenesis of hepatogenic diabetes.Methods The fasting and 2-hour postprandial plasma glucose,fasting sertum insulin,glutamate decarboxylase antibody,insulin release index (IRI)and insulin sensitivity index(ISI)Was determined and analyzed in 135 liver cirrhosis patients.Results The incidence of hepatogenic diabetes wag 39.3%(53/135)in liver cirrhosis patients.The incidence of hepatogenic diabetes in post hepatitis C liver cirrhosis patients(53.3%.16/30)was muchh igher than that in post hepatitis B liver cirrhosis patients(37.1%,26/70)and alcohofic liver cirrhosis patients(31.4%.11/35)(P＜0.01).The fasting serum insulin,IRI and the positivity rate of glutamate decarboxylase antibody was much higher in hepatogenic diabetes than that in controls(P＜0.01),and ISl was much lower than that in controls(P＜0.01).Conclusions The development of hepatogenic diabetics is relsted with the etiological factor of liver cirrhosis.Besides impairment of the hepatocellular function and insulin resistance,viral infection and immunologic derangement and so on results in impairment of beta cell of islet function.Relative or absolute deficiency of insulin secretion is an important influential factor in the development of hepatogenic diabetics.