Clinical features of post-hepatitis B liver cirrhosis associated with diabetes mellitus

Objective To study the clinical features of post-hepatitis B liver cirrhosis (LC) that are associated with diabetes mellitus (LCDM) and distinctive from type 2 diabetes mellitus (T2DM) without HBV infection or LC.Methods One-hundred-and-six post-hepatitis B LCDM patients and 112 T2DM patients were analyzed.All patients underwent oral glucose tolerance test (OGTT) , insulin release test (IRT) , C-peptide release test (CRT) , and glucagon (Glu) test.The homeostasis model assessment of insulin resistance (HOMA-IR) index, HOMA beta cell function (HOMA-β) , and modified beta cell function index (MBCI) were calculated.Between group differences were statistically analyzed.ResultsThe OGTT glucose levels were consistently significantly lower in LCDM than in T2DM (P<0.001) .Some insulin levels (30, 60, 120, 180min) were significantly higher in LCDM (P<0.001) .The fasting and 30 min insulin levels were not significantly different.The postprandial C-peptide levels (60, 120, 180min) were significantly higher in LCDM (P<0.05) .Glu was much higher in LCDM (P<0.05) , and the percentage of patients with abnormally elevated Glu was also significantly different between the two groups (P<0.001) .Eighty-three percent of LCDM patients had normal fasting glucose, and their diabetes mellitus was diagnosed by abnormal postprandial glucose.The percentage of patients with abnormal fasting glucose was significantly lower in the LCDM group (P<0.001) .Lower than normal glucose levels were much more prevalent in the T2DM group (P<0.01) .The HOMA-IR was lower in LCDM (P<0.01) .The HOMA-β and MBCI were similar between the two groups (P>0.05) .Conclusion Post-hepatitis B LCDM has several clinical features that are distinctive from T2DM, including postprandial glucose, OGTT curve, IRT curve, CRT curve, Glu, insulin resistance index, and lower fasting glucose.The features of insulin resistance and abnormally increased Glu may be one of the main causes of DM in HBV-related cirrhotic patients.