Unlabelled: The effect of diabetes on cirrhosis, its decompensation, and their time relationship in chronic hepatitis C (CHC) patients remains unclear. We conducted a nation-wide cohort study by using the Taiwanese National Health Insurance Research Database, which is comprised of data from >99% of the entire population. Among having randomly sampled 1 million enrollees, 6,251 adult CHC patients were identified from 1997 to 2009. Diabetes was defined as new onset in CHC patients who were given the diagnosis in the years 1999-2003, but not in 1997-1998. The cohorts of CHC with new-onset diabetes (n=424) and nondiabetes (n=1,708) were followed up from inception point in diabetes and from year 1999 in the nondiabetes cohort until development of cirrhosis or its decompensation, withdrawal from insurance, or December 2009. Kaplan-Meier's survival analysis showed a significantly higher cumulative incidence of cirrhosis (relative risk [RR]=1.53; 95% confidence interval [CI]=1.11-2.11; log-rank test; P<0.001) and decompensated cirrhosis (RR=2.01; 95% CI=1.07-3.79; log-rank test; P<0.001) among patients with new-onset diabetes, as compared to those without. After adjustment for age, gender, CHC treatment, diabetes treatment, hepatocellular carcinoma, comorbidity index, hypertension, hyperlipidemia, and obesity by Cox's proportional hazard model, diabetes was still an independent predictor for cirrhosis (hazard ratio [HR]=2.505; 95% CI=1.609-3.897; P<0.001) and its decompensation (HR=3.560; 95% CI=1.526-8.307; P=0.003).
Conclusion: CHC patients who develop diabetes are at an increased risk of liver cirrhosis and its decompensation over time.
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http://dx.doi.org/10.1002/hep.27212 | DOI Listing |
Aliment Pharmacol Ther
January 2025
School of Medicine, College of Medicine, National Sun Yat-sen University, Kaohsiung, Taiwan.
Background And Aims: Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) and sodium-glucose cotransporter-2 inhibitors (SGLT2is) have demonstrated long-term liver benefits in patients with metabolic dysfunction-associated steatotic liver disease (MASLD) and type 2 diabetes (T2D). However, no direct comparison between these therapies has been conducted. This study aimed to compare major adverse liver outcomes (MALOs) between GLP-1 RAs and SGLT2is in patients with MASLD and T2D.
View Article and Find Full Text PDFZhonghua Gan Zang Bing Za Zhi
December 2024
Department of Infectious Disease Medicine, Fifth Medical Center, PLA General Hospital, National Clinical Research Center of Infectious Diseases, Beijing100039, China.
End-stage liver disease includes liver failure and decompensated cirrhosis resulting from various etiologies and often leads to patient mortality due to complications and clinical symptoms such as severe jaundice, ascites, hepatic encephalopathy, coagulopathy, and hepatorenal syndrome. Liver transplantation is currently regarded as the most effective treatment, but its clinical application is limited by the shortage of donors, elevated expenses, and post-transplant rejection. Stem cells are a group of cells with multidirectional differentiation potential and self-renewal ability, which can improve the clinical indicator outcomes through mechanisms such as immunoregulation and promotion of tissue repair in patients with end-stage liver disease.
View Article and Find Full Text PDFThromb Haemost
January 2025
Division of Gastroenterology, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Bangkok, Thailand.
Background: Clot waveform analysis (CWA) provides a global assessment of hemostasis and may be useful for patients with cirrhosis with complex hemostatic abnormalities. This study aimed to assess the association between prothrombin time (PT-) and activated partial thromboplastin time (aPTT-) based CWA parameters and cirrhosis severity and prospectively evaluate the role of CWA in predicting mortality and acute decompensation (AD) over 1 year.
Methods: This prospective study included adult patients with cirrhosis between June 2021 and December 2023 at Chulalongkorn University Hospital.
Biomark Med
January 2025
Department of Laboratory Medicine, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China.
Objective: The prognostic value of neutrophil-to-lymphocyte ratio (NLR) combined with Model for End-Stage Liver Disease (MELD) score was evaluated for hepatitis B virus-associated decompensated cirrhosis (HBV-DeCi).
Methods: The 30-day mortality of 166 hBV-DeCi patients was examined. Receiver operating characteristic curve analysis and multivariate regression analysis were used to assess the performance of NLR for prediction of poor outcomes.
Background And Aims: Metabolic dysfunction-associated steatotic liver disease (MASLD) has a global prevalence of 25%. Studies on incident liver and cardiovascular outcomes in lean (Body mass index: BMI < 25 kg/m, or < 23 kg/m for Asians) vs. non-lean individuals with MASLD have reported mixed results.
View Article and Find Full Text PDFEnter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!