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conferenceseries
.com
Volume 8, Issue 10 (Suppl)
J Diabetes Metab
ISSN: 2155-6156 JDM, an open access journal
Herbal Diabetes 2017
November 02-04, 2017
November 02-04, 2017 Bangkok, Thailand
23
rd
International Conference on
Herbal and Alternative Remedies for
Diabetes and Endocrine Disorders
Surging prevalence of cryptogenic cirrhosis in type-2 diabetes mellitus: An alarming fact or a big
illusory bias?
Abbas Tavakolian Arjmand
Azad University of Shahrood, Iran
Background & Aim:
A growing body of evidence considers the cryptogenic cirrhosis as the immediate offspring of Type-2
Diabetes Mellitus (T2DM). We would suggest that, the majority of reported cases of cryptogenic cirrhosis are actually the result
of surreptitious or under-estimated alcohol consumption in conjunction with underlying metabolic syndrome, not the direct
consequence or a chronic complication of T2DM. For further clarification of the issue, a population of T2DM patients living
in a closed religious society where alcohol production, distribution and consumption were legally and ritually banned, were
investigated for manifestations of cirrhosis and end-stage liver disease.
Materials & Methods:
In a prospective observational study, 132 T2DM patients (43 males and 89 females) were consecutively
enrolled. They were interviewed and carefully investigated for any stigmata of chronic liver failure and cirrhosis. Then, an all-
inclusive panel of liver function tests completed with viral markers, immunological markers and abdominal sonography were
carried out. Liver biopsy was considered once academically and ethically indicated.
Results:
The average age of patients was 58±10.9 years (range, 31-83 years), and the duration of diabetes was 7.4±6 years
(range, 1-25 years). BMI came out as 34.9±5.3 with mean waist circumference of 71.2±11.5 cm. To our surprise, from 132
T2DM patients only eight (6%) displayed mild to moderate abnormal liver enzyme levels, of which only 2 cases had liver
enzyme levels of more than twice normal. With regard to our main concern, only two subjects (1.5%) manifested overt liver
failure and cirrhosis, of which, one person tested positive for HCVAb and the other disclosed eventually to have been drinking
alcohol heavily at younger ages for years while living abroad.
Conclusion:
We would suggest, if alcoholic liver disease as a major confounding variable- becomes efficiently eliminated
from the relevant studies, T2DM, per se, would seldom persist as a direct causative risk for cryptogenic cirrhosis. We believe
that T2DM, NAFLD and cryptogenic cirrhosis are all the results of a superior pathogenic process, the metabolic syndrome or
better to say insulin resistance syndrome. As a matter of fact, the terrifying prevalence of cryptogenic cirrhosis is the outcome
of awful impact of hyperinsulinemia of metabolic syndrome on surreptitious and over-looked alcoholic liver disease.
Biography
Abbas Tavakolian Arjmand is an Associate Professor at Shahrood Azad University of Medical Sciences, Iran. His research interest is in metabolic syndrome,
obesity, insulin/IGF-1 Receptor cross-talk and PCOS. He has wide range of publications in various national and international journals.
dr.tavakolian@gmail.comAbbas Tavakolian Arjmand, J Diabetes Metab 2017, 8:10 (Suppl)
DOI: 10.4172/2155-6156-C1-072