Asociación de cirrosis hepática con diabetes mellitus tipo 2 en pacientes mayores de 40 años en el Hospital IESS Ceibos-periodo enero 2019 a enero 2023.

Abstract

Introduction: The liver plays a central role in glucose metabolism, releasing it during fasting and storing it as postprandial glycogen. In patients with cirrhosis, these metabolic processes are altered, leading to a high prevalence of glucose intolerance and diabetes. Two types of diabetes are identified in relation to cirrhosis: type 2 diabetes mellitus, associated with metabolic syndrome, and hepatogenic diabetes, which appears as a direct complication of liver dysfunction. Objective: Toassociate liver cirrhosis with type 2 diabetes mellitus in patients older than 40 yearsat the Hospital General del Norte de Guayaquil IESS Los Ceibos- period January 2019 to January 2023.Methods: Retrospective, cross-sectional, analytical study. Spearman's Rho correlation method was used to assess the relationship between blood glucose and stages of cirrhosis. Relative risks (OR) were calculated to estimate the probability of poor glycemic control in patients with advanced cirrhosis (Child-Pugh B and C). Results: Of the 103 patients, 59.2% were in Child-Pugh A, 23.3% B, 17.5% C. It was observed that patients in Child-Pugh B and C had a 5.14 times higher risk of presenting fasting glucose >130 mg/dL compared to Child-Pugh A. Regarding glycosylated hemoglobin (HbA1c) levels, Child-Pugh B and C patients had a 3.85 times higher risk of having HbA1c levels >6.5%. Patients with obesity had a 7.92-fold increased risk of developing advanced cirrhosis (Child-Pugh B and C) compared to those without obesity. Likewise, obesity significantly increased the risk of poor glycemic control. A significant positive correlation was found between glucose levels and degree of cirrhosis, with a correlation coefficient of 0.577 (P<0.01). The greater the degree of cirrhosis, the greater was the glycemic dyscontrol. Conclusions: We conclude that there is a significant association between the severity of liver cirrhosis and poor glycemic control in patients with type 2 diabetes mellitus.