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Patients with diabetes at increased risk for mortality from chronic liver disease

Patients with diabetes displayed an increased risk for mortality by chronic liver disease, according to recent study data.

Researchers collected data from death certificates in northern Italy to determine etiologies (virus-related, alcohol-related, or nonvirus, nonalcohol-related incidence, primarily due to nonalcoholic fatty liver disease) of patients who had been diagnosed with diabetes (n=176,771) in December 2007 and later died from chronic liver disease (CLD).

Among 167,621 patients and 473,374 person-years of follow-up between 2008 and 2010, 17,134 deaths were recorded. The majority were attributed to cardiovascular disease (34.6%) and neoplasms (31%). CLD-related deaths occurred in 2.3% of cases, representing 47.2% of the deaths associated with digestive diseases.

Investigators said men (standardized mortality ratio=2.47; 95% CI, 2.19-2.78) and women (SMR=2.7; 95% CI, 2.24-3.23) with diabetes had an increased risk for mortality from CLD. Data also showed these men and women had a significantly greater risk for mortality than the overall population with SMRs of 1.49 (95% CI, 1.46-1.52) and 1.53 (95% CI, 1.49-1.56), respectively.

In subanalysis, the SMR was greatest among deceased who had nonvirus, nonalcohol-related CLD (2.86; 95% CI, 2.65-3.08), followed by alcohol-related (SMR=2.25; 95% CI, 1.98-2.54) and virus-related CLD (SMR=2.17; 95% CI, 1.9-2.47).

“Our study shows that diabetic patients are exposed to a two-to threefold increased risk of mortality from CLD,” the researchers concluded. “The main cause of the excess mortality related to CLD seems to be attributable to nonalcoholic fatty liver disease.

“For such reasons, strategies to prevent CLD-related deaths should include not only vaccination against viral hepatitis and education on the particularly deleterious effects of alcohol in diabetes, but also effective campaigns to reduce body weight and avoid weight gain.”

Disclosure: The researchers report no relevant financial disclosures.