Prevalence and Risk Factors of Diabetes Mellitus in Patients with Autoimmune Hepatitis.

Abstract

OBJECTIVE:

The administration of corticosteroids is a standard treatment for autoimmune hepatitis (AIH), but it can occasionally induce various adverse effects. Diabetes mellitus (DM) is a major complication of chronic liver diseases. We investigated the prevalence and risk factors of DM in patients with AIH.

METHODS:

We retrospectively analyzed 118 Japanese patients diagnosed with AIH from 1990 to 2014 at our institution. The prognosis of patients with and without DM was also compared.

RESULTS:

Twenty-nine (24.5%) patients had DM and 21 (72.4%) received corticosteroids. The annual cumulative incidence rate of newly diagnosed DM was 1.2%. Multivariate analysis showed that DM occurred in older patients [OR=6.290; 95% confidence interval (CI)=1.230-32.100; p=0.018] with higher serum immunoglobulin G levels (OR=12.400; 95% CI=2.560-60.400; p=0.002). A Cox hazard regression analysis revealed that predictive factors for DM were absence of other autoimmune diseases (OR=0.171; 95% CI=0.036-0.805; p=0.025), use of corticosteroids (OR=6.693; 95% CI=1.391-32.210; p=0.049) and lower platelet counts (OR=3.873; 95% CI=1.021-14.690; p=0.046). The 10 year survival rates of the DM and non-DM groups were 94.1% and 94.6%, respectively. There was no significant difference between these groups (p=0.293).

CONCLUSION:

DM occurred in 24.5% of patients with AIH; older age, absence of other autoimmune diseases and higher serum immunoglobulin G levels are risk factors. Taking corticosteroids and a lower platelet count are risk factors for a new onset of DM. DM did not influence the prognosis of AIH patients.

• Authors: Naoki Matsumoto, Masahiro Ogawa, Shunichi Matsuoka, Mitsuhiko Moriyama
• Journal: Internal medicine (Tokyo, Japan) (Intern Med) Vol. 55 Issue 8 Pg. 879-85 ( 2016) ISSN: 1349-7235 [Electronic] Japan
• PMID: 27086799 (Publication Type: Journal Article)

Chemical References

• Adrenal Cortex Hormones

Topics

• Adrenal Cortex Hormones (therapeutic use)
• Adult
• Age Factors
• Aged
• Aged, 80 and over
• Diabetes Mellitus (epidemiology)
• Female
• Hepatitis, Autoimmune (drug therapy, epidemiology)
• Humans
• Japan (epidemiology)
• Male
• Middle Aged
• Multivariate Analysis
• Platelet Count
• Prevalence
• Prognosis
• Retrospective Studies
• Risk Factors
• Survival Rate