Recent Developments in the Diagnosis of Hepatogenous Diabetes

doi:10.12114/j.issn.1007-9572.2021.00.068

Abstract

Abstract: Hepatogenous diabetes（HD）can be defined as a kind of glucose metabolic disorders secondary to impaired liver functions caused by liver cirrhosis，the final stage of chronic liver disease associated with progressive liver fibrosis. HD may increase the risk of common complications of liver cirrhosis，such as hepatic encephalopathy，upper gastrointestinal bleeding，spontaneous peritonitis，ascites and infection，as well as the risk of progression from cirrhosis to liver cancer and the mortality of liver cancer. As glycemic control is an effective means to improve the prognosis of HD，early identifying and intervening HD are of great clinical significance. At present，it is still difficult to make a clinical diagnosis of HD，and there are no systematic diagnostic strategies for HD in China. In this paper，we reviewed the recent developments in HD diagnosis，with a view to helping early clinical identification of HD to improve the prognosis of patients with liver cirrhosis.

Key words: Liver cirrhosis, Diabetes mellitus, Hepatogenous diabetes, Impaired glucose tolerance, Insulin resistance, Glucose tolerance test, Diagnosis, Review

摘要： 肝硬化是与进行性肝纤维化相关的慢性肝病的最后阶段，而继发于肝硬化的糖代谢紊乱被称为肝源性糖尿病（HD）。HD不仅会增加肝性脑病、上消化道出血、自发性腹膜炎、腹腔积液及感染等肝硬化常见并发症发生率，还会增加肝硬化进展为肝癌的风险及肝癌患者死亡率。由于控制血糖可有效改善HD患者预后，因此HD的早期识别及干预具有重要临床意义。目前，HD的临床诊断较困难，国内亦未系统地提出HD的诊断策略。本文对近年来关于HD诊断的研究进展进行了综述，以期帮助临床早期识别HD，减少肝硬化患者不良预后。

关键词: 肝硬化, 糖尿病, 肝源性糖尿病, 糖耐量受损, 胰岛素抵抗, 葡糖耐量实验, 诊断, 综述

TIAN Caiyun,HU Han,ZHANG Guoyuan, et al. Recent Developments in the Diagnosis of Hepatogenous Diabetes　[J]. Chinese General Practice, 2021, 24(9): 1158-1164. DOI: 10.12114/j.issn.1007-9572.2021.00.068.
田彩云,胡晗,张国远等. 肝源性糖尿病的诊断研究进展[J]. 中国全科医学, 2021, 24(9): 1158-1164. DOI: 10.12114/j.issn.1007-9572.2021.00.068.

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