Prospective Study On The Association Between Fasting Glucose Concentrations And Liver Cirrhosis Risk

Background:Several previous cross-sectional epidemiology studies have shown theincidence risk of liver cirrhosis among diabetes mellitus (DM) patients has asignificant increase. Similarly patients with liver cirrhosis have higher riskof developing DM which suggest that glycometabolism disorders includingDM, hyperglycemia and hyperinsulinemia may associate with liver cirrhosisincidence. However the evidence is insufficient to illustrate the causalrelationship and no previous researches has investigated on the associationbetween glucose levels in healthy adults and risk of liver cirrhosis.Objective:To explore the association between concentrations of fasting serumglucose and liver cirrhosis risk in Chinese population. To verify theetiological role of elevated glucose concentrations in the incidence of livercirrhosis and provide scientific evidence for further investigations.Method:A nested case-control study was carried out based on the Nutrition Intervention Trial which was conducted in Linxian.310liver cirrhoses and620healthy individuals were included as case and control groups. Usingautomatic biochemical analysis system and enzyme-linked immunoassay,baseline serum samples of study participants were tested for fasting glucoseconcentration, surface antigen and core antibody to Hepatitis virus B andantibody to Hepatitis virus C. Baseline information was collected via aquestionnaire. The serum glucose values were divided into quintiles.Logistic regression model was used to estimate odds ratios and95%confidence intervals.Results:1.A statistically significant difference of serum glucose concentrationswas observed between cases (4.5±1.8)mmol/l and controls(4.2±2.1)mmol/lwith t=-2.414and P=0.016.2.The distribution of cases in different quintiles varies with statisticalsignificance (X2=11.11, P=0.025, DF=4).3.Compare the individuals in the highest quintile to the lowest(Referent), a higher risk of diseases was found with OR=1.672(1.080,2.588). With the increase of the glucose level, the risk was elevated withstatistically significant linearity trend(P=0.002). After adjusted withpotential confounders including sex, age, HBsAg, anti-HBc and alcoholconsumption status, the significance sustained with OR=1.96(1.216,3.157),P for trend=0.001. Conclusions:1.The study found that healthy adults with elevated fasting glucoselevels have a higher risk of developing cirrhosis than those with lower.2.Elevated serum fasting glucose concentration was suggested to be apotential independent risk factor of liver cirrhosis and this effect isindependent of demographic indicators, HBsAg, Anti-HCV and alcoholconsumption status.