Low Incidence of Vascular Complications in Patients with Diabetes Mellitus Associated with Liver Cirrhosis as Compared with Type 2 Diabetes Mellitus

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  • Fujiwara Fumikado
    Department of Diabetes and Metabolism, School of Medicine, Iwate Medical University
  • Ishii Mototsugu
    Department of Diabetes and Metabolism, School of Medicine, Iwate Medical University
  • Taneichi Haruhito
    Department of Diabetes and Metabolism, School of Medicine, Iwate Medical University
  • Miura Masanori
    Department of Diabetes and Metabolism, School of Medicine, Iwate Medical University
  • Toshihiro Makiko
    Department of Diabetes and Metabolism, School of Medicine, Iwate Medical University
  • Takebe Noriko
    Department of Diabetes and Metabolism, School of Medicine, Iwate Medical University
  • Ishida Wataru
    Department of Diabetes and Metabolism, School of Medicine, Iwate Medical University
  • Kaneko Yoshihito
    Department of Diabetes and Metabolism, School of Medicine, Iwate Medical University
  • Kato Akinobu
    The First Department of Internal Medicine, School of Medicine, Iwate Medical University
  • Suzuki Kazuyuki
    The First Department of Internal Medicine, School of Medicine, Iwate Medical University
  • Satoh Jo
    Department of Diabetes and Metabolism, School of Medicine, Iwate Medical University

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Abstract

We compared clinical features and vascular complications of patients with diabetes mellitus associated with liver cirrhosis versus patients with type 2 diabetes mellitus. Subjects were 19 patients (LC-DM group) in whom diabetes was diagnosed after development of liver cirrhosis. Control consisted of 38 patients with type 2 diabetes (T2DM group) matched for sex, age, duration of diabetes, body mass index, treatment, and degree of glycemic control, which was determined by glycoalbumin. The LC-DM group had significantly more smokers, higher serum insulin levels, more insulin resistance calculated by homeostasis model assessment, lower blood counts (white and red blood cells, hemoglobin, and platelets), and lower serum levels of total cholesterol, triglyceride, low density lipoprotein cholesterol and lipoprotein (Lp)(a) than the T2DM group. The incidence of diabetic retinopathy and cerebrovascular disease was significantly lower in the LC-DM group compared to the T2DM group. Logistic regression analysis indicated that Lp(a) and the diabetes duration were significant predictors for the retinopathy, while Lp(a) was a significant predictor for the cerebrovascular complication. In diabetes associated with liver cirrhosis, the incidence of diabetic retinopathy and cerebrovascular disease is lower than in type 2 diabetes mellitus in this study, probably because of lower levels of serum Lp(a).

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