Mechanisms for increased risk of diabetes in chronic liver diseases

• DOI: 10.1111/liv.14556
• Publication Date: 2020-06-09T13:21:04Z
• Authors: Gianluca Svegliat...; Melania Gaggini; Fabrizia Carli; Chiara Barbieri; Monica Cucco; Ramy Younes; Chiara Rosso; Elisabetta Bugianesi; Amalia Gastaldelli
• Keywords: Blood Glucose; 0301 basic medicine; diabetes; Blood Glucose; Glucose Tolerance Test; Humans; Insulin; Diabetes Mellitus, Type 2; Insulin Resistance; Non-alcoholic Fatty Liver Disease; chronic liver disease; non-alcoholic fatty liver disease; Glucose Tolerance Test; 3. Good health; 03 medical and health sciences; Diabetes Mellitus, Type 2; Non-alcoholic Fatty Liver Disease; insulin resistance; Humans; Insulin; chronic hepatitis; Insulin Resistance

Patients with chronic liver disease (CLD), both non-alcoholic fatty (NAFLD) and hepatitis C (CHC), are at high risk of diabetes (T2D), but mechanisms still unknown. Muscle/liver insulin resistance (IR) pancreatic dysfunction the major metabolic defects leading to T2D. However, if T2D in CLD patients is because reduced response and/or IR, impact histology has not been investigated.We studied 220 non-T2D (129 NAFLD, BMI = 27.3 kg/m2 ; 91 CHC, 25.0 ) that received a 75-gram oral glucose tolerance test (OGTT) measurement concentrations for 2 hours, (NGT vs IGT) biopsy. The results were compared 26 controls (CT-NGT, 25.6 ). We evaluated peripheral sensitivity (OGIS), OGTT-insulin (ΔAUC-I/ΔAUC-G) disposition-index (DI OGIS∙ΔAUC-I/ΔAUC-G) develop T2D.NAFLD had increased muscle IR (associated NASH, steatosis fibrosis), higher than CHC or CT-NGT (OGIS 8.9 11.3 10.5 mL/min kg, P < .0001). In was highest while it significantly decreased (2.2 1.1 1.6, NAFLD vs. CT-NGT, .005). (low DI) observed CHC-IGT (7.5), CHC-NGT (13.5) NAFLD-IGT (10.8) (14.9, all .0001), NAFL-NGT NASH-NGT.We an NAFLD-IGT, mainly response, NAFLD-NGT compensates thus maintaining normal glycaemia.