Diabetes mellitus is an independent prognostic factor for major liver‐related outcomes in patients with cirrhosis and chronic hepatitis C
In patients with chronic hepatitis C (CHC), cirrhosis is associated with age, gender, diabetes, alcohol abuse, and coinfection with human immunodeficiency virus (HIV) or hepatitis B virus (HBV). The effect of these factors on the outcome of cirrhosis is unknown. This study in CHC patients with cirrh...
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| Veröffentlicht in: | Hepatology (Baltimore, Md.) Md.), 2014-09, Vol.60 (3), p.823-831 |
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| creator | Elkrief, Laure Chouinard, Pascale Bendersky, Noelle Hajage, David Larroque, Béatrice Babany, Gérard Kutala, Blaise Francoz, Claire Boyer, Nathalie Moreau, Richard Durand, François Marcellin, Patrick Rautou, Pierre‐Emmanuel Valla, Dominique |
| description | In patients with chronic hepatitis C (CHC), cirrhosis is associated with age, gender, diabetes, alcohol abuse, and coinfection with human immunodeficiency virus (HIV) or hepatitis B virus (HBV). The effect of these factors on the outcome of cirrhosis is unknown. This study in CHC patients with cirrhosis aimed to assess the influence of these factors on decompensation, liver transplantation, and death. Consecutive patients with CHC and cirrhosis hospitalized between January 1, 2006 and December 31, 2008 were followed up until death, transplantation, or study closure in March 2013. Gender, age, Model for End‐Stage Liver Disease (MELD) score, diabetes, alcohol abuse, HIV, or HBV coinfection were collected at inclusion. The complications of cirrhosis, death, and liver transplantation were recorded at inclusion and during follow‐up. The association between baseline factors and liver‐related outcomes at inclusion and during follow‐up were tested using logistic regression and Cox's model, respectively. A total of 348 patients with CHC and cirrhosis (68% men; median age: 59 years; median MELD: 10) were included. At baseline, 40% of the patients had diabetes, 29% alcohol abuse, and 6% HIV or HBV coinfection. Baseline MELD ≥10 (P |
| doi_str_mv | 10.1002/hep.27228 |
| format | Article |
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The effect of these factors on the outcome of cirrhosis is unknown. This study in CHC patients with cirrhosis aimed to assess the influence of these factors on decompensation, liver transplantation, and death. Consecutive patients with CHC and cirrhosis hospitalized between January 1, 2006 and December 31, 2008 were followed up until death, transplantation, or study closure in March 2013. Gender, age, Model for End‐Stage Liver Disease (MELD) score, diabetes, alcohol abuse, HIV, or HBV coinfection were collected at inclusion. The complications of cirrhosis, death, and liver transplantation were recorded at inclusion and during follow‐up. The association between baseline factors and liver‐related outcomes at inclusion and during follow‐up were tested using logistic regression and Cox's model, respectively. A total of 348 patients with CHC and cirrhosis (68% men; median age: 59 years; median MELD: 10) were included. At baseline, 40% of the patients had diabetes, 29% alcohol abuse, and 6% HIV or HBV coinfection. Baseline MELD ≥10 (P < 0.001), diabetes (P = 0.027), and HBV coinfection (P = 0.001) were independently associated with transplantation‐free survival. Baseline diabetes was independently associated with ascites (P = 0.05), bacterial infections (P = 0.001), and encephalopathy (P < 0.001) at inclusion. Baseline diabetes was independently associated with development of ascites (P = 0.057), renal dysfunction (P = 0.004), bacterial infections (P = 0.007), and hepatocellular carcinoma (P = 0.016) during the follow‐up. Conclusion: In patients with CHC and cirrhosis, diabetes is an independent prognostic factor. Improving diabetes control may improve the outcome of cirrhosis. (Hepatology 2014;60:823–831)</description><identifier>ISSN: 0270-9139</identifier><identifier>EISSN: 1527-3350</identifier><identifier>DOI: 10.1002/hep.27228</identifier><identifier>PMID: 24841704</identifier><identifier>CODEN: HPTLD9</identifier><language>eng</language><publisher>United States: Wolters Kluwer Health, Inc</publisher><subject>Aged ; Bacterial infections ; Carcinoma, Hepatocellular - epidemiology ; Carcinoma, Hepatocellular - etiology ; Carcinoma, Hepatocellular - virology ; Diabetes ; Diabetes Complications - diagnosis ; Diabetes Complications - mortality ; Diabetes Complications - virology ; Female ; France - epidemiology ; Hepatitis ; Hepatitis B - complications ; Hepatitis C ; Hepatitis C, Chronic - complications ; Hepatitis C, Chronic - epidemiology ; Hepatitis C, Chronic - virology ; Hepatology ; HIV ; Human immunodeficiency virus ; Humans ; Liver cirrhosis ; Liver Cirrhosis - diagnosis ; Liver Cirrhosis - mortality ; Liver Cirrhosis - virology ; Liver Neoplasms - epidemiology ; Liver Neoplasms - etiology ; Liver Neoplasms - virology ; Liver Transplantation ; Male ; Middle Aged ; Prognosis ; Retrospective Studies ; Risk Factors</subject><ispartof>Hepatology (Baltimore, Md.), 2014-09, Vol.60 (3), p.823-831</ispartof><rights>2014 by the American Association for the Study of Liver Diseases</rights><rights>2014 by the American Association for the Study of Liver Diseases.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4218-6dd7ae58afe4cf5939739a4c05b84d08b36c2a92093905f0091932688dd8bb123</citedby><cites>FETCH-LOGICAL-c4218-6dd7ae58afe4cf5939739a4c05b84d08b36c2a92093905f0091932688dd8bb123</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fhep.27228$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fhep.27228$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24841704$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Elkrief, Laure</creatorcontrib><creatorcontrib>Chouinard, Pascale</creatorcontrib><creatorcontrib>Bendersky, Noelle</creatorcontrib><creatorcontrib>Hajage, David</creatorcontrib><creatorcontrib>Larroque, Béatrice</creatorcontrib><creatorcontrib>Babany, Gérard</creatorcontrib><creatorcontrib>Kutala, Blaise</creatorcontrib><creatorcontrib>Francoz, Claire</creatorcontrib><creatorcontrib>Boyer, Nathalie</creatorcontrib><creatorcontrib>Moreau, Richard</creatorcontrib><creatorcontrib>Durand, François</creatorcontrib><creatorcontrib>Marcellin, Patrick</creatorcontrib><creatorcontrib>Rautou, Pierre‐Emmanuel</creatorcontrib><creatorcontrib>Valla, Dominique</creatorcontrib><title>Diabetes mellitus is an independent prognostic factor for major liver‐related outcomes in patients with cirrhosis and chronic hepatitis C</title><title>Hepatology (Baltimore, Md.)</title><addtitle>Hepatology</addtitle><description>In patients with chronic hepatitis C (CHC), cirrhosis is associated with age, gender, diabetes, alcohol abuse, and coinfection with human immunodeficiency virus (HIV) or hepatitis B virus (HBV). The effect of these factors on the outcome of cirrhosis is unknown. This study in CHC patients with cirrhosis aimed to assess the influence of these factors on decompensation, liver transplantation, and death. Consecutive patients with CHC and cirrhosis hospitalized between January 1, 2006 and December 31, 2008 were followed up until death, transplantation, or study closure in March 2013. Gender, age, Model for End‐Stage Liver Disease (MELD) score, diabetes, alcohol abuse, HIV, or HBV coinfection were collected at inclusion. The complications of cirrhosis, death, and liver transplantation were recorded at inclusion and during follow‐up. The association between baseline factors and liver‐related outcomes at inclusion and during follow‐up were tested using logistic regression and Cox's model, respectively. A total of 348 patients with CHC and cirrhosis (68% men; median age: 59 years; median MELD: 10) were included. At baseline, 40% of the patients had diabetes, 29% alcohol abuse, and 6% HIV or HBV coinfection. Baseline MELD ≥10 (P < 0.001), diabetes (P = 0.027), and HBV coinfection (P = 0.001) were independently associated with transplantation‐free survival. Baseline diabetes was independently associated with ascites (P = 0.05), bacterial infections (P = 0.001), and encephalopathy (P < 0.001) at inclusion. Baseline diabetes was independently associated with development of ascites (P = 0.057), renal dysfunction (P = 0.004), bacterial infections (P = 0.007), and hepatocellular carcinoma (P = 0.016) during the follow‐up. Conclusion: In patients with CHC and cirrhosis, diabetes is an independent prognostic factor. Improving diabetes control may improve the outcome of cirrhosis. (Hepatology 2014;60:823–831)</description><subject>Aged</subject><subject>Bacterial infections</subject><subject>Carcinoma, Hepatocellular - epidemiology</subject><subject>Carcinoma, Hepatocellular - etiology</subject><subject>Carcinoma, Hepatocellular - virology</subject><subject>Diabetes</subject><subject>Diabetes Complications - diagnosis</subject><subject>Diabetes Complications - mortality</subject><subject>Diabetes Complications - virology</subject><subject>Female</subject><subject>France - epidemiology</subject><subject>Hepatitis</subject><subject>Hepatitis B - complications</subject><subject>Hepatitis C</subject><subject>Hepatitis C, Chronic - complications</subject><subject>Hepatitis C, Chronic - epidemiology</subject><subject>Hepatitis C, Chronic - virology</subject><subject>Hepatology</subject><subject>HIV</subject><subject>Human immunodeficiency virus</subject><subject>Humans</subject><subject>Liver cirrhosis</subject><subject>Liver Cirrhosis - diagnosis</subject><subject>Liver Cirrhosis - mortality</subject><subject>Liver Cirrhosis - virology</subject><subject>Liver Neoplasms - epidemiology</subject><subject>Liver Neoplasms - etiology</subject><subject>Liver Neoplasms - virology</subject><subject>Liver Transplantation</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Prognosis</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><issn>0270-9139</issn><issn>1527-3350</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kcFO3DAQhi1UVLa0B14AWeqFHgJjx944R7RQqIRED-05cmyH9SqJg-2AuPXeS5-xT8IsS3uo1IPH0vjzp_k1hBwxOGUA_GztplNeca72yIJJXhVlKeENWQCvoKhZWR-QdyltAKAWXL0lB1wowSoQC_LzwuvWZZfo4Pre5zlRn6geqR-tmxyWMdMphrsxpOwN7bTJIdIOz6A3WHv_4OLvH7-i63V2loY5mzCgz4900tnj_0QffV5T42Nch_Sit9SsYxhRiLMjlbG7ek_2O90n9-H1PiTfP19-W10XN7dXX1bnN4URnKliaW2lnVS6c8J0si7rqqy1MCBbJSyotlwarmsO-AKyw9CsLvlSKWtV2zJeHpKTnRdz3c8u5WbwyWB8Pbowp4ZJWYFCkCH68R90E-Y44nRbSlZCSdhSn3aUiSGl6Lpmin7Q8alh0Gw31GDK5mVDyB6_Gud2cPYv-WclCJztgEffu6f_m5rry6875TP6SpzF</recordid><startdate>201409</startdate><enddate>201409</enddate><creator>Elkrief, Laure</creator><creator>Chouinard, Pascale</creator><creator>Bendersky, Noelle</creator><creator>Hajage, David</creator><creator>Larroque, Béatrice</creator><creator>Babany, Gérard</creator><creator>Kutala, Blaise</creator><creator>Francoz, Claire</creator><creator>Boyer, Nathalie</creator><creator>Moreau, Richard</creator><creator>Durand, François</creator><creator>Marcellin, Patrick</creator><creator>Rautou, Pierre‐Emmanuel</creator><creator>Valla, Dominique</creator><general>Wolters Kluwer Health, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>7TM</scope><scope>7TO</scope><scope>7U9</scope><scope>H94</scope><scope>K9.</scope><scope>7X8</scope></search><sort><creationdate>201409</creationdate><title>Diabetes mellitus is an independent prognostic factor for major liver‐related outcomes in patients with cirrhosis and chronic hepatitis C</title><author>Elkrief, Laure ; Chouinard, Pascale ; Bendersky, Noelle ; Hajage, David ; Larroque, Béatrice ; Babany, Gérard ; Kutala, Blaise ; Francoz, Claire ; Boyer, Nathalie ; Moreau, Richard ; Durand, François ; Marcellin, Patrick ; Rautou, Pierre‐Emmanuel ; Valla, Dominique</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4218-6dd7ae58afe4cf5939739a4c05b84d08b36c2a92093905f0091932688dd8bb123</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Aged</topic><topic>Bacterial infections</topic><topic>Carcinoma, Hepatocellular - epidemiology</topic><topic>Carcinoma, Hepatocellular - etiology</topic><topic>Carcinoma, Hepatocellular - virology</topic><topic>Diabetes</topic><topic>Diabetes Complications - diagnosis</topic><topic>Diabetes Complications - mortality</topic><topic>Diabetes Complications - virology</topic><topic>Female</topic><topic>France - epidemiology</topic><topic>Hepatitis</topic><topic>Hepatitis B - complications</topic><topic>Hepatitis C</topic><topic>Hepatitis C, Chronic - complications</topic><topic>Hepatitis C, Chronic - epidemiology</topic><topic>Hepatitis C, Chronic - virology</topic><topic>Hepatology</topic><topic>HIV</topic><topic>Human immunodeficiency virus</topic><topic>Humans</topic><topic>Liver cirrhosis</topic><topic>Liver Cirrhosis - diagnosis</topic><topic>Liver Cirrhosis - mortality</topic><topic>Liver Cirrhosis - virology</topic><topic>Liver Neoplasms - epidemiology</topic><topic>Liver Neoplasms - etiology</topic><topic>Liver Neoplasms - virology</topic><topic>Liver Transplantation</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Prognosis</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Elkrief, Laure</creatorcontrib><creatorcontrib>Chouinard, Pascale</creatorcontrib><creatorcontrib>Bendersky, Noelle</creatorcontrib><creatorcontrib>Hajage, David</creatorcontrib><creatorcontrib>Larroque, Béatrice</creatorcontrib><creatorcontrib>Babany, Gérard</creatorcontrib><creatorcontrib>Kutala, Blaise</creatorcontrib><creatorcontrib>Francoz, Claire</creatorcontrib><creatorcontrib>Boyer, Nathalie</creatorcontrib><creatorcontrib>Moreau, Richard</creatorcontrib><creatorcontrib>Durand, François</creatorcontrib><creatorcontrib>Marcellin, Patrick</creatorcontrib><creatorcontrib>Rautou, Pierre‐Emmanuel</creatorcontrib><creatorcontrib>Valla, Dominique</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>Nucleic Acids Abstracts</collection><collection>Oncogenes and Growth Factors Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Hepatology (Baltimore, Md.)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Elkrief, Laure</au><au>Chouinard, Pascale</au><au>Bendersky, Noelle</au><au>Hajage, David</au><au>Larroque, Béatrice</au><au>Babany, Gérard</au><au>Kutala, Blaise</au><au>Francoz, Claire</au><au>Boyer, Nathalie</au><au>Moreau, Richard</au><au>Durand, François</au><au>Marcellin, Patrick</au><au>Rautou, Pierre‐Emmanuel</au><au>Valla, Dominique</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Diabetes mellitus is an independent prognostic factor for major liver‐related outcomes in patients with cirrhosis and chronic hepatitis C</atitle><jtitle>Hepatology (Baltimore, Md.)</jtitle><addtitle>Hepatology</addtitle><date>2014-09</date><risdate>2014</risdate><volume>60</volume><issue>3</issue><spage>823</spage><epage>831</epage><pages>823-831</pages><issn>0270-9139</issn><eissn>1527-3350</eissn><coden>HPTLD9</coden><abstract>In patients with chronic hepatitis C (CHC), cirrhosis is associated with age, gender, diabetes, alcohol abuse, and coinfection with human immunodeficiency virus (HIV) or hepatitis B virus (HBV). The effect of these factors on the outcome of cirrhosis is unknown. This study in CHC patients with cirrhosis aimed to assess the influence of these factors on decompensation, liver transplantation, and death. Consecutive patients with CHC and cirrhosis hospitalized between January 1, 2006 and December 31, 2008 were followed up until death, transplantation, or study closure in March 2013. Gender, age, Model for End‐Stage Liver Disease (MELD) score, diabetes, alcohol abuse, HIV, or HBV coinfection were collected at inclusion. The complications of cirrhosis, death, and liver transplantation were recorded at inclusion and during follow‐up. The association between baseline factors and liver‐related outcomes at inclusion and during follow‐up were tested using logistic regression and Cox's model, respectively. A total of 348 patients with CHC and cirrhosis (68% men; median age: 59 years; median MELD: 10) were included. At baseline, 40% of the patients had diabetes, 29% alcohol abuse, and 6% HIV or HBV coinfection. Baseline MELD ≥10 (P < 0.001), diabetes (P = 0.027), and HBV coinfection (P = 0.001) were independently associated with transplantation‐free survival. Baseline diabetes was independently associated with ascites (P = 0.05), bacterial infections (P = 0.001), and encephalopathy (P < 0.001) at inclusion. Baseline diabetes was independently associated with development of ascites (P = 0.057), renal dysfunction (P = 0.004), bacterial infections (P = 0.007), and hepatocellular carcinoma (P = 0.016) during the follow‐up. Conclusion: In patients with CHC and cirrhosis, diabetes is an independent prognostic factor. Improving diabetes control may improve the outcome of cirrhosis. (Hepatology 2014;60:823–831)</abstract><cop>United States</cop><pub>Wolters Kluwer Health, Inc</pub><pmid>24841704</pmid><doi>10.1002/hep.27228</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Aged Bacterial infections Carcinoma, Hepatocellular - epidemiology Carcinoma, Hepatocellular - etiology Carcinoma, Hepatocellular - virology Diabetes Diabetes Complications - diagnosis Diabetes Complications - mortality Diabetes Complications - virology Female France - epidemiology Hepatitis Hepatitis B - complications Hepatitis C Hepatitis C, Chronic - complications Hepatitis C, Chronic - epidemiology Hepatitis C, Chronic - virology Hepatology HIV Human immunodeficiency virus Humans Liver cirrhosis Liver Cirrhosis - diagnosis Liver Cirrhosis - mortality Liver Cirrhosis - virology Liver Neoplasms - epidemiology Liver Neoplasms - etiology Liver Neoplasms - virology Liver Transplantation Male Middle Aged Prognosis Retrospective Studies Risk Factors |
| title | Diabetes mellitus is an independent prognostic factor for major liver‐related outcomes in patients with cirrhosis and chronic hepatitis C |
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