Cargando…

Liver-related long-term outcomes of alpha-glucosidase inhibitors in patients with diabetes and liver cirrhosis

Background: Adequate management of diabetes in patients with liver cirrhosis can be challenging. We conducted this study to investigate the liver-related long term outcomes of alpha-glucosidase inhibitors (AGIs) in patients with diabetes and cirrhosis. Methods: From National Health Insurance Researc...

Descripción completa

Detalles Bibliográficos
Autores principales: Yen, Fu-Shun, Hou, Ming-Chih, Wei, James Cheng-Chung, Shih, Ying-Hsiu, Hsu, Chung Y., Hsu, Chih-Cheng, Hwu, Chii-Min
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9812564/
https://www.ncbi.nlm.nih.gov/pubmed/36618937
http://dx.doi.org/10.3389/fphar.2022.1049094
_version_ 1784863756011962368
author Yen, Fu-Shun
Hou, Ming-Chih
Wei, James Cheng-Chung
Shih, Ying-Hsiu
Hsu, Chung Y.
Hsu, Chih-Cheng
Hwu, Chii-Min
author_facet Yen, Fu-Shun
Hou, Ming-Chih
Wei, James Cheng-Chung
Shih, Ying-Hsiu
Hsu, Chung Y.
Hsu, Chih-Cheng
Hwu, Chii-Min
author_sort Yen, Fu-Shun
collection PubMed
description Background: Adequate management of diabetes in patients with liver cirrhosis can be challenging. We conducted this study to investigate the liver-related long term outcomes of alpha-glucosidase inhibitors (AGIs) in patients with diabetes and cirrhosis. Methods: From National Health Insurance Research Database (NHIRD) in Taiwan, we recruited propensity-score matched alpha-glucosidase inhibitor users and non-users from a cohort of type 2 diabetes mellitus (T2DM) with compensated liver cirrhosis between 1 January 2000, and 31 December 2017, and followed them until 31 December 2018. Cox proportional hazards models with robust sandwich standard error estimates were used to assess the risk of main outcomes for alpha-glucosidase inhibitor users versus non-users. Results: The incidence rates of mortality during follow-up were 65.56 vs. 96.06 per 1,000 patient-years for alpha-glucosidase inhibitor users and non-users, respectively. The multivariable-adjusted model shows that alpha-glucosidase inhibitor users had significantly lower risks of all-cause mortality (aHR 0.63, 95% CI 0.56–0.71), hepatocellular carcinoma (aHR 0.55, 95% CI 0.46–0.67), decompensated cirrhosis (aHR 0.74 95% CI 0.63–0.87), hepatic encephalopathy (aHR 0.72, 95% CI 0.60–0.87), and hepatic failure (aHR 0.74, 95% CI 0.62–0.88) than alpha-glucosidase inhibitor non-users. Patients who received alpha-glucosidase inhibitors for a cumulative duration of more than 364 days had significantly lower risks of these outcomes than non-users. Conclusion: Alpha-glucosidase inhibitor use was associated with a lower risk of mortality, hepatocellular carcinoma, decompensated cirrhosis, and hepatic failure in patients with diabetes and compensated cirrhosis. alpha-glucosidase inhibitors may be useful for the management of diabetes in patients with compensated liver cirrhosis. Large-scale prospective studies are required to verify our results.
format Online
Article
Text
id pubmed-9812564
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher Frontiers Media S.A.
record_format MEDLINE/PubMed
spelling pubmed-98125642023-01-05 Liver-related long-term outcomes of alpha-glucosidase inhibitors in patients with diabetes and liver cirrhosis Yen, Fu-Shun Hou, Ming-Chih Wei, James Cheng-Chung Shih, Ying-Hsiu Hsu, Chung Y. Hsu, Chih-Cheng Hwu, Chii-Min Front Pharmacol Pharmacology Background: Adequate management of diabetes in patients with liver cirrhosis can be challenging. We conducted this study to investigate the liver-related long term outcomes of alpha-glucosidase inhibitors (AGIs) in patients with diabetes and cirrhosis. Methods: From National Health Insurance Research Database (NHIRD) in Taiwan, we recruited propensity-score matched alpha-glucosidase inhibitor users and non-users from a cohort of type 2 diabetes mellitus (T2DM) with compensated liver cirrhosis between 1 January 2000, and 31 December 2017, and followed them until 31 December 2018. Cox proportional hazards models with robust sandwich standard error estimates were used to assess the risk of main outcomes for alpha-glucosidase inhibitor users versus non-users. Results: The incidence rates of mortality during follow-up were 65.56 vs. 96.06 per 1,000 patient-years for alpha-glucosidase inhibitor users and non-users, respectively. The multivariable-adjusted model shows that alpha-glucosidase inhibitor users had significantly lower risks of all-cause mortality (aHR 0.63, 95% CI 0.56–0.71), hepatocellular carcinoma (aHR 0.55, 95% CI 0.46–0.67), decompensated cirrhosis (aHR 0.74 95% CI 0.63–0.87), hepatic encephalopathy (aHR 0.72, 95% CI 0.60–0.87), and hepatic failure (aHR 0.74, 95% CI 0.62–0.88) than alpha-glucosidase inhibitor non-users. Patients who received alpha-glucosidase inhibitors for a cumulative duration of more than 364 days had significantly lower risks of these outcomes than non-users. Conclusion: Alpha-glucosidase inhibitor use was associated with a lower risk of mortality, hepatocellular carcinoma, decompensated cirrhosis, and hepatic failure in patients with diabetes and compensated cirrhosis. alpha-glucosidase inhibitors may be useful for the management of diabetes in patients with compensated liver cirrhosis. Large-scale prospective studies are required to verify our results. Frontiers Media S.A. 2022-12-21 /pmc/articles/PMC9812564/ /pubmed/36618937 http://dx.doi.org/10.3389/fphar.2022.1049094 Text en Copyright © 2022 Yen, Hou, Wei, Shih, Hsu, Hsu and Hwu. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Pharmacology
Yen, Fu-Shun
Hou, Ming-Chih
Wei, James Cheng-Chung
Shih, Ying-Hsiu
Hsu, Chung Y.
Hsu, Chih-Cheng
Hwu, Chii-Min
Liver-related long-term outcomes of alpha-glucosidase inhibitors in patients with diabetes and liver cirrhosis
title Liver-related long-term outcomes of alpha-glucosidase inhibitors in patients with diabetes and liver cirrhosis
title_full Liver-related long-term outcomes of alpha-glucosidase inhibitors in patients with diabetes and liver cirrhosis
title_fullStr Liver-related long-term outcomes of alpha-glucosidase inhibitors in patients with diabetes and liver cirrhosis
title_full_unstemmed Liver-related long-term outcomes of alpha-glucosidase inhibitors in patients with diabetes and liver cirrhosis
title_short Liver-related long-term outcomes of alpha-glucosidase inhibitors in patients with diabetes and liver cirrhosis
title_sort liver-related long-term outcomes of alpha-glucosidase inhibitors in patients with diabetes and liver cirrhosis
topic Pharmacology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9812564/
https://www.ncbi.nlm.nih.gov/pubmed/36618937
http://dx.doi.org/10.3389/fphar.2022.1049094
work_keys_str_mv AT yenfushun liverrelatedlongtermoutcomesofalphaglucosidaseinhibitorsinpatientswithdiabetesandlivercirrhosis
AT houmingchih liverrelatedlongtermoutcomesofalphaglucosidaseinhibitorsinpatientswithdiabetesandlivercirrhosis
AT weijameschengchung liverrelatedlongtermoutcomesofalphaglucosidaseinhibitorsinpatientswithdiabetesandlivercirrhosis
AT shihyinghsiu liverrelatedlongtermoutcomesofalphaglucosidaseinhibitorsinpatientswithdiabetesandlivercirrhosis
AT hsuchungy liverrelatedlongtermoutcomesofalphaglucosidaseinhibitorsinpatientswithdiabetesandlivercirrhosis
AT hsuchihcheng liverrelatedlongtermoutcomesofalphaglucosidaseinhibitorsinpatientswithdiabetesandlivercirrhosis
AT hwuchiimin liverrelatedlongtermoutcomesofalphaglucosidaseinhibitorsinpatientswithdiabetesandlivercirrhosis