| Title: |
Prevalence and natural history of histologically proven chronic liver disease in a longitudinal cohort of patients with type 1 diabetes |
| Authors: |
Harman, David; Harris, Rebecca; Aithal, Guruprasad; Kaye, Philip; Suzuki, Ayako; Gazis, Anastasios |
| Publisher Information: |
Wiley |
| Publication Year: |
2014 |
| Collection: |
University of Nottingham: Repository@Nottingham |
| Description: |
Although a higher prevalence of raised liver enzymes and altered echotexture on ultrasound have been reported in patients with type 1 diabetes mellitus (T1DM), the histological spectrum and natural history of chronic liver disease (CLD) in T1DM is unknown. We investigated the prevalence and outcome of histologically proven CLD in a longitudinal cohort of patients with T1DM. We identified patients who have had liver biopsy from a computerized database (DIAMOND; Hicom Technology, Brookwood, UK) containing longitudinal data for over 95% of type 1 diabetes patients from an overall catchment population of 700,000 people. Gender-matched patients with oral hypoglycemic-treated (T2OH) and insulin-treated type 2 diabetes (T2IN) who had liver biopsy formed two comparative cohorts. We collated clinical and histological data, as well as long-term outcomes of all three groups, and compared T1DM cirrhosis incidence to UK general population data. Of 4,644 patients with T1DM, 57 (1.2%) underwent liver biopsy. Of these, 53.1% of patients had steatosis, 20.4% had nonalcoholic steatohepatitis, and 73.5% had fibrosis on index liver biopsy. Cirrhosis was diagnosed in 14 patients (24.6%) during follow-up. T1DM with age under 55 years had an odds ratio of 1.875 (95% confidence interval: 0.936-3.757) for cirrhosis incidence, compared to the general population. Longitudinal liver-related outcomes were similar comparing the T1DM cohort and respective type 2 diabetes cohorts—when adjusted for important confounders, diabetic cohort type did not predict altered risk of incident cirrhosis or portal hypertension. Conclusion: Type 1 diabetes is associated with a previously unrecognized burden of CLD and its complications. (Hepatology 2014;60:158–168) |
| Document Type: |
article in journal/newspaper |
| Language: |
English |
| Relation: |
https://nottingham-repository.worktribe.com/output/1100076; Hepatology; Volume 60; Issue 1; Pagination 158-168 |
| DOI: |
10.1002/hep.27098 |
| Availability: |
https://doi.org/10.1002/hep.27098; https://nottingham-repository.worktribe.com/file/1100076/1/Hepatology%20-%202014%20-%20Harman%20-%20Prevalence%20and%20natural%20history%20of%20histologically%20proven%20chronic%20liver%20disease%20in%20a; https://nottingham-repository.worktribe.com/output/1100076 |
| Rights: |
openAccess ; No License Set (All rights reserved) |
| Accession Number: |
edsbas.68D5CBF1 |
| Database: |
BASE |