Prevalence and predictive factors of diabetes in hepatitis virus positive liver cirrhosis with fasting plasma glucose level of <126mg/dL

Aim: The aim of this study was to evaluate the prevalence and predictive factors of diabetes in hepatitis virus positive liver cirrhotic patients with fasting plasma glucose (FPG) level of <126mg/dL. Methods: A total of 263 patients with hepatitis C virus (HCV) or hepatitis B virus (HBV) positive liver cirrhosis, FPG level of <126mg/dL, and had diabetes status evaluated by the use of 75-g oral glucose tolerance test (OGTT), were enrolled in this study. Plasma glucose and insulin levels were analyzed periodically for 3h after oral glucose loading. Diabetes was defined as a 2-h post-load glucose on the OGTT of ≥200mg/dL. The prevalence of diabetes by use of OGTT and predictive factors for diabetes were evaluated by the use of the Mann-Whitney U-test, Fisher's exact probability test or multivariate analysis by logistic regression. Hypoalbuminemia was defined as serum albumin level of <3.9g/dL. Elevated indocyanine green retention rate at 15min (ICG _R15) was regarded as ≥ 25%. Results: Out of 263 patients, 44 (16.7%) were diagnosed as having diabetes. Multivariate analysis showed that diabetes occurred when patients had hypoalbuminemia of <3.9g/dL (odds ratio [OR] 2.33; 95% confidential interval [CI]=1.04-5.24; P=0.040) and ICG _R15 of <25% (OR 2.36; 95%CI=1.01-5.58). Conclusions: Hypoalbuminemia and elevated ICG _R15 in hepatitis virus related cirrhotic patients with FPG level of <126mg/day enhance diabetes pattern after OGTT with significant difference.