Prevalence and correlation of diabetes with severity of liver cirrhosis and utility of HbA1c in these patients as compared with oral glucose tolerance test /
انتشار و علاقة مرضى السكرى بمدى شدة تشمع الكبد وذلك باتستخدام الهيموجلوبين السكرى مقارنة باختبار تحمل الجلوكوز عن طريق الفم
Seham Mostafa Othman ; Supervised Iman Hamza , Mona Zaki , Sherief Musa
- Cairo : Seham Mostafa Othman , 2021
- 82 P. : charts , facsimiles ; 25cm
Thesis (M.Sc.) - Cairo University - Faculty of Medicine - Department of Tropical Medicine
Background: patients with chronic liver disease regardless the etiology are at an increased risk of developing type 2 diabetes mellitus which is an essential morbidity. We aimed to understand the distribution of prediabetes and diabetes in these patients and their correlation of liver disease severity using HbA1c in diagnosing of diabetes as compared with oral glucose tolerance test. methods: we reported 180 patients,120 patients with confirmed cirrhosis regardless the etiology and 60 control diabetic patients. A 75 gm OGTT (0 and 2nd hour) was administrated for glycaemic status categorization. The severity of chronic liver disease was calculated by using the Child-Turcotte-Pugh score. Utility of HbA1c was compard with OGTT. results: The mean age of the 180 patients was 57.2±6.1 years. 30.8% of cirrhotic patients were class A, 57.5% were class B and 11.7 % were class C. 61.7% of cirrhotic group patients had normal Hb level to mild anaemia and 38.3 % had moderate to severe anaemia. Both HbA1C and OGTT (0-2h) had high statistical significance in control group than cirrhotic group (p<0.0001).The 180 patients were classified according to prevalence of diabetes into 3 independent groups depending on OGT.Cirrhotic DM group (87 patients),Cirrhotic without DM group (33 patients) and Control DM group (60 patients). Among cirrhotic patients 72.5% of patients had DM and 27.5 had IGT. HbA1c level at cut off point >6.5 predicted moderate to severe anaemic group with fair accuracy 75% and mild anemic group with 71% accuracy (p<0.01). HbA1c showed non significant predictive value in discrimination of DM in patients with child A (P>0.05), but it can predict DM in child B group with poor accuracy (p=0.0068) and child C also with poor accuracy (p=0.039). Hb and albumin had negative correlation with HbA1c in cirrhotic patients(p<0.05). Hb had high significant negative correlation with OGTT (p=0.0093)