Prevalence of diabetes mellitus in patients with end-stage liver cirrhosis due to hepatitis C, alcohol, or cholestatic disease

Zein, Nizar N.; Abdul‐Karim, Ahmad; Wiesner, Russell H.; Egan, Kathleen S.; Persing, David H.

doi:10.1016/s0168-8278(00)80065-3

Cited by 227 publications

(191 citation statements)

References 43 publications

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“…In the 10 cases reported in this article, diabetes was present in six patients (60%), while complications related to liver cirrhosis, as hepatocellular carcinoma, spontaneous bacterial peritonitis and portosystemyc encephalopathy were present in 5 patients. A strict association between diabetes mellitus and liver cirrhosis exists, in particular an increased risk of developing diabetes mellitus is present in patients with liver cirrhosis due to hepatitis C and alcoholic liver disease while the risk is reduced in liver cirrhosis due to cholestatic liver disease [7]. Development of mucormycosis in cirrhotic patients with associated diabetes mellitus may reflect compromised immunity of the patient from diabetes mellitus more than liver disease.…”

Section: Discussionmentioning

confidence: 99%

Liver cirrhosis and rhino-orbital mucormycosis, a possible but rare association: description of a clinical case and literature review

Pellicelli

D’Ambrosio²,

Villani³

et al. 2009

Braz J Infect Dis

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Section: Discussionmentioning

confidence: 99%

Liver cirrhosis and rhino-orbital mucormycosis, a possible but rare association: description of a clinical case and literature review

Pellicelli

D’Ambrosio²,

Villani³

et al. 2009

Braz J Infect Dis

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“…The prevalence of type 2 diabetes is higher in patients with HCV-associated MC than in the general population [80]. Metabolic disorders in HCV-infected patients may be related to the development of steatosis or cirrhosis, whose clinical significance in HCV-infected patients has recently been emphasized [81].…”

Section: Diabetes Mellitusmentioning

confidence: 99%

“…HCV may independently contribute to the development of diabetes. A high insulin resistance has been found in patients with chronic HCV infection [80,82]. The role of HCV therapy and its effect on diabetes is a matter of debate.…”

Section: Diabetes Mellitusmentioning

confidence: 99%

Hepatitis C virus and autoimmunity

Böckle

Sepp

2010

Autoimmun Highlights

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Hepatitis C virus infection is associated with several extrahepatic manifestations. About 60% of patients infected with HCV develop at least one extrahepatic manifestation. The majority of these diseases seem to be triggered through autoimmune mechanisms, such as autoantibody production, autoreactive T cells and complex autoimmune mechanisms leading to systemic autoimmune disorders. In this review we categorize these diseases into three groups according to the main pathogenetic process involved, in particular B-cell-mediated, T-cell-mediated and complex autoimmune systemic diseases.

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“…Despite the lack of universal agreement, some studies have observed worsened short-and mid-term survival among diabetic LT recipients. [1][2][3][4][5][6][7] Furthermore, DM is a wellknown risk factor for cardiovascular disease, which is one of the leading causes of death of LT recipients in the long term. 8 Calcineurin inhibitors (CI) also predispose to DM through islet cell toxicity, diminished insulin synthesis or release, as well as decreased peripheral insulin sensitivity.…”

Section: D Abetes Mellitus (Dm)mentioning

confidence: 99%

Conversion from calcineurin inhibitors to mycophenolate mofetil in liver transplant recipients with diabetes mellitus

Herrero¹,

Quiroga²,

Sangro³

et al. 2003

Transplantation Proceedings

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Diabetes mellitus, a frequent metabolic complication in liver transplant recipients, may be produced by the diabetogenic effect of calcineurin inhibitors cyclosporine and tacrolimus. The aim of this study was to investigate the safety and metabolic effects of a gradual switch from cyclosporine or tacrolimus to mycophenolate mofetil among 12 diabetic liver transplant recipients. One patient was withdrawn from the study due to gastrointestinal side effects. Of the 11 remaining patients, cyclosporine or tacrolimus was completely withdrawn in five patients. Two patients developed suspected acute rejection episodes that were controlled by increasing the tacrolimus dosage. Glycosylated hemoglobin A1C and C-peptide levels were significantly lower at 3 and 6 months after the initiation of mycophenolate mofetil (P < .03 in all cases). Furthermore, urea and uric acid levels were significantly reduced after the change of treatment. In conclusion, a switch from cyclosporine/tacrolimus to mycophenolate mofetil may produce beneficial metabolic effects in diabetic liver transplant recipients, but poses a risk of graft rejection. I D ABETES MELLITUS (DM) is a frequent metabolic complication in liver transplant(LT) recipients. Despite the lack of universal agreement, some studies have observed worsened short-and mid-term survival among diabetic LT recipients. 1-7 Furthermore, DM is a wellknown risk factor for cardiovascular disease, which is one of the leading causes of death of LT recipients in the long term. 8 Calcineurin inhibitors (CI) also predispose to DM through islet cell toxicity, diminished insulin synthesis or release, as well as decreased peripheral insulin sensitivity. 9 Mycophenolate mofetil (MMF) has proven to be useful as a CI-sparing agent. The use of MMF has allowed physicians to reduce cyclosporine exposure in LT recipients with renal functional impairment. 10 Some patients have been maintained on MMF monotherapy, but this strategy poses the risk of graft rejection. 11 The aim of the present study was to examine whether conversion to MMF for stable LT recipients with DM allows the reduction/withdrawal of CI and results in improve metabolic control.From the Liver Unit (J.I.H., J.Q., B.S., J.P.) and

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Prevalence of diabetes mellitus in patients with end-stage liver cirrhosis due to hepatitis C, alcohol, or cholestatic disease

Cited by 227 publications

References 43 publications

Liver cirrhosis and rhino-orbital mucormycosis, a possible but rare association: description of a clinical case and literature review

Liver cirrhosis and rhino-orbital mucormycosis, a possible but rare association: description of a clinical case and literature review

Hepatitis C virus and autoimmunity

Conversion from calcineurin inhibitors to mycophenolate mofetil in liver transplant recipients with diabetes mellitus

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