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Diabetes independently linked with infection, ascites risk in CHC, cirrhosis

Diabetes was an independent prognostic factor for various liver-related outcomes, including development of bacterial infection and ascites, among patients with chronic hepatitis C virus and cirrhosis, according to new study data.

Researchers analyzed variables such as gender, MELD score and diabetes from 348 patients with chronic hepatitis C virus (CHC) and cirrhosis. At baseline, 40% of patients had diabetes, 29% alcohol abuse and 6% had HIV or hepatitis B virus (HBV). The patients with cirrhosis tended to be male, aged at least 60 years, diagnosed with diabetes and HIV/HBV coinfection, and showed symptoms of alcohol abuse.

Final analysis excluded the 49% of patients who died before liver transplantation and the 21% who underwent transplantation. Of the remaining 104 patients, MELD scores of 10 or greater (P<.001), diabetes (P=.027) and HBV coinfection (P=.001) were independently associated with survival without transplantation. Diabetes affected survival without transplantation only in patients with MELD scores less than 10.

Twenty-five percent of patients without ascites at baseline developed ascites during follow-up, leading researchers to conclude that diabetes (P=.057) and other factors were independently associated with ascites development. Baseline diabetes also was independently associated with developing renal dysfunction (P=.004), bacterial infections (P=.007) and hepatocellular carcinoma (P=.016). At inclusion, baseline diabetes was independently associated with bacterial infections (P=.001) and encephalopathy (P<.001).

“The present study provides solid evidence that diabetes is a risk factor for complications in patients with CHC-related cirrhosis admitted to the hospital, resulting in a shortened transplantation-free survival independent from the baseline MELD score,” the researchers concluded. “Our results suggest that this factor has prognostic value as an indicator of advanced liver disease, or so-called hepatogenous diabetes, as well as being a precipitating factor of the complications of cirrhosis.”

Disclosure: The researchers report no relevant financial disclosures.