Diabetes
Increases The Risk of Liver Failure- Another Complication
According
to findings from a large Veterans Affairs cohort study, diabetic
patients are at an increased risk of developing acute liver failure.
Drs.
El-Serag from the Houston Department of Veterans Affairs Medical
Center and Dr. Everhart from the National Institute of Diabetes and
Digestive and Kidney Diseases identified all the patients in the VA
database who were discharged with a diagnosis of diabetes from 1985 to
1990. They compared these patients to a randomly selected cohort of
nondiabetic patients. The final study cohort included 173,643 diabetic
patients and 650,620 nondiabetic patients who were followed through
2000, according to the report in the June issue of Gastroenterology.
Among
diabetic patients, the cumulative risk of acute liver failure was
significantly higher compared with nondiabetic patients (incidence
rate 2.31 per 10,000 person years versus 1.44 per 10,000 person years,
p<0.0001), Drs. El-Serag and Everhart found.
Analysis
that controlled for comorbidity, age, sex, ethnicity, and period of
military service found that diabetes was associated with a relative
risk of 1.44 for developing acute liver failure (p<0.0001).
This
association remained significant after excluding patients who
developed viral hepatitis during followup and those with acute liver
failure after troglitazone was introduced (relative risk 1.40,
p<0.0001).
Drs.
El-Serag and Everhart advise that "periodic monitoring of liver
enzymes and caution in the use of potentially hepatotoxic drugs may be
warranted in patients with diabetes."
Gastroenterology
2002;122:1822-1828.
