Hepatogenous diabetes:Knowledge,evidence,and skepticism  

作　　者：Ramesh Kumar Diego García-Compeán Tanmoy Maji 

机构地区：[1]Department of Gastroenterology,All India Institute of Medical Sciences,Patna 801507,Bihar,India [2]Department of Gastroenterology,University Hospital,Universidad Autónoma de Nuevo León,México,Monterrey 64700,México

出　　处：《World Journal of Hepatology》2022年第7期1291-1306,共16页世界肝病学杂志（英文版）（电子版）

摘　　要：The diabetogenic potential of liver cirrhosis(LC)has been known for a long time,and the name"hepatogenous diabetes"(HD)was coined in 1906 to define the condition.Diabetes mellitus(DM)that develops as a consequence of LC is referred to as HD.In patients with LC,the prevalence rates of HD have been reported to vary from 21%to 57%.The pathophysiological basis of HD seems to involve insulin resistance(IR)and pancreaticβ-cell dysfunction.The neurohormonal changes,endotoxemia,and chronic inflammation of LC initially create IR;however,the toxic effects eventually lead toβ-cell dysfunction,which marks the transition from impaired glucose tolerance to HD.In addition,a number of factors,including sarcopenia,sarcopenic obesity,gut dysbiosis,and hyperammonemia,have recently been linked to impaired glucose metabolism in LC.DM is associated with complications and poor outcomes in patients with LC,although the individual impact of each type 2 DM and HD is unknown due to a lack of categorization of diabetes in most published research.In fact,there is much skepticism within scientific organizations over the recognition of HD as a separate disease and a consequence of LC.Currently,T2DM and HD are being treated in a similar manner although no standardized guidelines are available.The different pathophysiological basis of HD may have an impact on treatment options.This review article discusses the existence of HD as a distinct entity with high prevalence rates,a strong pathophysiological basis,clinical and therapeutic implications,as well as widespread skepticism and knowledge gaps.

关 键 词：CIRRHOSIS DIABETES Hepatogenous diabetes Glucose intolerance Insulin resistance METABOLISM 

分 类 号：R575.2[医药卫生—消化系统] R587.2[医药卫生—内科学]