Low Incidence of Vascular Complications in Patients with Diabetes Mellitus Associated with Liver Cirrhosis as Compared with Type 2 Diabetes Mellitus

Fujiwara, Fumikado; Ishii, Mototsugu; Taneichi, Haruhito; Miura, Motoki; Toshihiro, Makiko; Takebe, Noriko; Ishida, Wataru; Kaneko, Yoshihito; Kato, Akinobu; Suzuki, Kazuyuki; Satoh, Jo

doi:10.1620/tjem.205.327

Cited by 20 publications

(20 citation statements)

References 31 publications

(15 reference statements)

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“…Visceral and subcutaneous abdominal fat were measured by cross-sectional CT scan using Multislice CT (Aquilion 16, Toshiba, Tokyo), as reported elsewhere (Fujiwara et al 2005). A single 10-mm thick slice at the ty lipoprotein-cholesterol (HDL-C), low density lipoprotein-cholesterol (LDL-C), and high-sensitive C-reactive protein (CRP) were measured by the Central Laboratory in our hospital.…”

Section: Methodsmentioning

confidence: 99%

Liver Fat Content Measured by Magnetic Resonance Spectroscopy at 3.0 Tesla Independently Correlates with Plasminogen Activator Inhibitor-1 and Body Mass Index in Type 2 Diabetic Subjects

Ishii

Yoshioka

Ishida

et al. 2005

Tohoku J. Exp. Med.

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We measured liver fat content by 3-Tesla magnetic resonance spectroscopy (MRS) in 34 non-to mild obese Japanese subjects with type 2 diabetes, who were not complicated with any liver diseases including clinical fatty liver (liver/spleen ratio of computed tomography [CT] < 0.9) and were not being treated with oral hypoglycemic agents, insulin, or lipid-lowering agents, and analyzed the relationship between liver fat content and body composition and plasma metabolite. The liver fat content is significantly correlated with variables relating to obesity (body mass index [BMI], body weight, fat mass, waist to hip ratio, visceral fat area, subcutaneous fat area, and serum triglyceride), insulin resistance (fasting plasma insulin and homeostasis model assessment of insulin resistance [HOMA-IR]), adipocytokines (serum plasminogen activator inhibitor-1 [PAI-1] and leptin), and serum cholinesterase, but not CT liver/spleen ratio, which is correlated only with fasting plasma glucose, BMI, and HOMA-IR. Multiple regression analysis revealed that the liver fat content is independently associated with serum PAI-1 level (p < 0.001) and BMI (p < 0.05), but not visceral fat area. MRS is a more sensitive method for quantifying liver fat content than CT in type 2 diabetic subjects with nonto mild obesity and without clinical fatty liver. type 2 diabetes; fatty liver; magnetic resonance spectroscopy; plasminogen activator inhibitor-1; body mass index

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Section: Methodsmentioning

confidence: 99%

Liver Fat Content Measured by Magnetic Resonance Spectroscopy at 3.0 Tesla Independently Correlates with Plasminogen Activator Inhibitor-1 and Body Mass Index in Type 2 Diabetic Subjects

Ishii

Yoshioka

Ishida

et al. 2005

Tohoku J. Exp. Med.

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“…The intima media thickness (IMT) was measured by ultrasonography (LOGIQ 500, GE Yokogawa Medical Systems Corp., Hino, Tokyo, Japan) as reported previously (10).…”

Section: Measurement Of the Cacs And Surrogate Markers Of Arteriosclementioning

confidence: 99%

Association of Coronary Artery Calcification with MDA-LDL-C/LDL-C and Urinary 8-Isoprostane in Japanese Patients with Type 2 Diabetes

et al. 2014

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Objective Oxidative stress has been implicated in the development of coronary artery calcification (CAC). However, there are few reports on this issue in Japanese patients with diabetes. In this study, we examined the association of the CAC score (CACS) with oxidative stress markers. Methods The study subjects were 163 Japanese patients with type 2 diabetes (75 men and 88 women). The CACS (Agatston unit: AU) was measured by multi-detector computed tomography (MDCT), and the oxidative stress markers, such as the urinary 8-isoprostane and 8-hydroxydeoxyguanosine (8-OHdG) and serum malondialdehyde (MDA)-LDL cholesterol were measured. The relationships between CACS and oxidative stress markers were statistically analyzed. Results Compared with the CACS 0-400 AU group (n=132), the age, duration of diabetes, urinary 8-isoprostane levels, serum MDA-LDL-C/LDL-C and maximum intima media thickness (IMT) were higher, and body mass index and HbA1c level were lower, in the CACS >400 AU group (n=31). The multiple logistic regression analysis showed that a CAC >400 AU was independently associated with the urinary 8-isoprostane (>median) (OR=2.54, 95% CI=1.03-6.32, p=0.044), MDA-LDL-C/LDL-C (>median) (OR=2.62, 95% CI=1.07-6.40, p=0.035) and HbA1c (>median) (OR=0.32, CI=0.12-0.87, p<0.025). Focusing on oxidative stress, a higher MDA-LDL-C/LDL-C (p=0.026) and a higher urinary 8-isoprostane level (p=0.074) were associated with the CACS. Conclusion The CACS was found to be independently associated with the MDA-LDL-C/LDL-C and urinary 8-isoprostane levels in Japanese patients with type 2 diabetes.

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“…Generally, the therapeutic strategy in DM is to reduce the incidence of cardiovascular disease and to prevent a subsequent decrease in quality of life and improve prognosis. However, hepatogenous DM is less often associated with a positive family history, retinopathy and cardiovascular diseases [18,[74][75][76] . In fact, major causes of death in cirrhotic patients with DM relate to liver disease or its complications, such as chronic liver failure, hepatocellular carcinoma (HCC) and gastrointestinal hemorrhage [18,19,[77][78][79] .…”

Section: Causes Of Death In Diabetic Patients With Liver Diseasementioning

confidence: 99%

Insulin resistance and chronic liver disease

Kawaguchi

Taniguchi²,

Itou³

et al. 2011

WJH

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Increased insulin resistance is frequently associated with chronic liver disease and is a pathophysiological feature of hepatogenous diabetes. Distinctive factors including hepatic parenchymal cell damage, portalsystemic shunting and hepatitis C virus are responsible for the development of hepatogenous insulin resistance/ diabetes. Although it remains unclear whether insulin secretion from pancreatic beta cells is impaired as it is in type 2 diabetes, retinopathic and cardiovascular risk is low and major causes of death in cirrhotic patients with diabetes are liver failure, hepatocellular carcinoma and gastrointestinal hemorrhage. Hemoglobin A1c is an inaccurate marker for the assessment and management of hepatogenous diabetes. Moreover, exogenous insulin or sulfonylureas may be harmful because these agents may promote hepatocarcinogenesis. Thus, pathogenesis, cause of death, assessment and therapeutic strategy for hepatogenous insulin resistance/diabetes differ from those for lifestyle-related type 2 diabetes. In this article, we review features of insulin resistance in relationship to chronic liver disease. We also discuss the impact of anti-diabetic agents on interferon treatment and hepatocarcinogenesis.

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Low Incidence of Vascular Complications in Patients with Diabetes Mellitus Associated with Liver Cirrhosis as Compared with Type 2 Diabetes Mellitus

Cited by 20 publications

References 31 publications

Liver Fat Content Measured by Magnetic Resonance Spectroscopy at 3.0 Tesla Independently Correlates with Plasminogen Activator Inhibitor-1 and Body Mass Index in Type 2 Diabetic Subjects

Liver Fat Content Measured by Magnetic Resonance Spectroscopy at 3.0 Tesla Independently Correlates with Plasminogen Activator Inhibitor-1 and Body Mass Index in Type 2 Diabetic Subjects

Association of Coronary Artery Calcification with MDA-LDL-C/LDL-C and Urinary 8-Isoprostane in Japanese Patients with Type 2 Diabetes

Insulin resistance and chronic liver disease

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