PDF(Pubmed)
Abstract：
Diabetes mellitus (DM) is common in liver cirrhosis (LC). The pathophysiological association is bidirectional. DM is a risk factor of LC and LC is a diabetogenic condition. In the recent years, research on different aspects of the association DM and LC has been intensified. Nevertheless, it has been insufficient and still exist many gaps. The aims of this review are: (1) To discuss the latest understandings of the association of DM and LC in order to identify the strategies of early diagnosis; (2) To evaluate the impact of DM on outcomes of LC patients; and (3) To select the most adequate management benefiting the two conditions. Literature searches were conducted using PubMed, Ovid and Scopus engines for DM and LC, diagnosis, outcomes and management. The authors also provided insight from their own published experience. Based on the published studies, two types of DM associated with LC have emerged: Type 2 DM (T2DM) and hepatogenous diabetes (HD). High-quality evidences have determined that T2DM or HD significantly increase complications and death pre and post-liver transplantation. HD has been poorly studied and has not been recognized as a complication of LC. The management of DM in LC patients continues to be difficult and should be based on drug pharmacokinetics and the degree of liver failure. In conclusion, the clinical impact of DM in outcomes of LC patients has been the most studied item recently. Nevertheless many gaps still exist particularly in the management. These most important gaps were highlighted in order to propose future lines for research.
摘要：
糖尿病（DM）常见于肝硬化（LC）。病理生理关联是双向的。DM是LC的危险因素，LC是一种糖尿病性疾病。近年来,加强了对DM和LC协会不同方面的研究。然而，它是不够的，仍然存在许多差距。这篇综述的目的是：（1）讨论对DM和LC相关性的最新理解，以确定早期诊断策略；（2）评估DM对LC患者预后的影响；（3）选择最适合这两种情况的管理。使用PubMed进行文献检索，用于DM和LC的Ovid和Scopus引擎，诊断,结果和管理。作者还从自己发表的经验中提供了见解。根据已发表的研究，出现了与LC相关的两种类型的DM：2型DM（T2DM）和肝源性糖尿病（HD）。高质量的证据表明，T2DM或HD显著增加肝移植前后的并发症和死亡。HD的研究很少，尚未被认为是LC的并发症。LC患者的DM管理仍然很困难，应基于药物药代动力学和肝功能衰竭的程度。总之,DM对LC患者结局的临床影响是最近研究最多的项目.然而，仍然存在许多差距，特别是在管理方面。强调了这些最重要的差距，以便提出未来的研究方向。
