Open AccessDiabetes mellitus is associated with gastroesophageal variceal bleeding in cirrhotic patients
Author(s) -
Yang ChunHsun,
Chiu YiChun,
Chen ChihHung,
Chen ChienHung,
Tsai MingChao,
Chuah SengKee,
Lee ChihHsiung,
Hu TsungHui,
Hung ChaoHung
Publication year - 2014
Publication title -
the kaohsiung journal of medical sciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.439
H-Index - 36
eISSN - 2410-8650
pISSN - 1607-551X
DOI - 10.1016/j.kjms.2014.06.002
Subject(s) - medicine , gastroenterology , cirrhosis , hepatic encephalopathy , ascites , odds ratio , spontaneous bacterial peritonitis , diabetes mellitus , endocrinology
Diabetes mellitus (DM) has been reported to increase the risk of complications of liver cirrhosis of any etiology and subsequent survival. However, the impact of DM on the development of gastroesophageal variceal bleeding (GEVB) remains unclear. We aimed to elucidate whether DM is an independent risk factor for GEVB among cirrhotic patients. A total of 146 consecutive patients with liver cirrhosis (Child‐Pugh Class A, n = 75; Class B, n = 40; and Class C, n = 31) were prospectively enrolled. Data on clinical and biochemical characteristics and history of ascites, GEVB, hepatic encephalopathy, and spontaneous bacterial peritonitis were retrospectively reviewed. Of these 146 patients, 37 (25%) had DM. Patients with DM had significantly higher ratio of Child‐Pugh Class B/C ( p = 0.043), renal insufficiency ( p = 0.002), and history of GEVB ( p = 0.006) compared with non‐DM patients. GEVB was associated with Child‐Pugh Class B/C ( p = 0.001), ascites ( p = 0.002), hepatic encephalopathy ( p = 0.023), and low platelet counts ( p < 0.001). Based on stepwise multiple logistic regression analysis, Child‐Pugh class B/C [odds ratio (OR) = 4.90, p = 0.003] and DM (OR = 2.99, p = 0.022) were identified as independent predictors of GEVB. In the subgroup analysis, DM significantly correlated with GEVB in patients with Child‐Pugh Class A ( p = 0.042), but not in patients with Child‐Pugh Class B/C ( p = 0.128). DM is independently associated with GEVB in cirrhotic patients, especially in those with Child‐Pugh Class A.