Table_1_Severe hypoglycemia in patients with liver cirrhosis and type 2 diabetes.DOCX

IntroductionAdvanced liver disease with massive liver damage may affect the metabolism of hypoglycemic agents and increase the risk of hypoglycemia. We conduct this research to compare the risk of severe hypoglycemia between patients with type 2 diabetes, with and without compensated liver cirrhosis.MethodsFrom Taiwan’s National Health Insurance Research Database, we identified persons with type 2 diabetes with cirrhosis (n = 18,209) and without cirrhosis (n = 538,510) from January 1, 2000, to December 31, 2010. Cox proportional hazards models were adopted to assess risks of all-cause mortality and severe hypoglycemia.ResultsThe mean follow-up period of this study was 3.7 years. The incidence rates of death during follow-up were 26.54 and 2.75 per 1,000 patient-years [aHR 7.63 (6.70–8.70)] for patients with cirrhosis and without cirrhosis, respectively. The incidence rates of severe hypoglycemia during follow-up were 0.53 and 0.14 per 1,000 patient-years [aHR 2.74 (1.52–4.92)] for patients with and without cirrhosis, respectively. The subgroup analysis of hypoglycemia risks in patients with and without cirrhosis disclosed no significant interaction for variables such as age, sex, chronic kidney disease, sulfonylurea use, number of oral antidiabetic drugs, insulin, b-blocker, and fibrate.ConclusionThis cohort study demonstrated that patients with type 2 diabetes and compensated cirrhosis showed a higher risk of mortality and severe hypoglycemia than those without liver cirrhosis.</p

The Risk of Severe Hypoglycemia and Mortality in Patients with Type 2 Diabetes and Discharged with Acute Liver Injury

OBJECTIVE To compare the risks of severe hypoglycemia and mortality between patients with type 2 diabetes (T2D) and discharged with and without acute liver injury. RESEARCH DESIGN AND METHODS From January 1, 2000, to December 31, 2010, we identified patients with T2D and hospitalization for acute liver injury and hospitalization for other causes from the National Health Insurance Research Database of Taiwan. Multivariable-adjusted Cox proportional hazards models were used to compare the risks of severe hypoglycemia and mortality between the study and control groups.  RESULTS The incidence rates and adjusted hazard ratios (aHRs) for severe hypoglycemia within 90 days and 365 days after discharge were 12.28 and 5.59 per 1000 person-years [aHR 1.92 (1.30-2.85)] and 7.35 and 2.9 per 1000 person-years [aHR 1.98 (1.52-2.58)] for patients discharged with and without acute liver injury, respectively. The incidence rates and aHRs for mortality within 90 days and 365 days after discharge were 82.4 and 27.54 per 1000 person-years [aHR 1.73 (1.46-2.05)] and 36.8 and 9.3 per 1000 person-years [aHR1.94 (1.69-2.24)] for patients discharged with and without acute liver injury, respectively. The subgroup analysis of hypoglycemia risk in patients discharged with acute liver injury revealed no significant interaction in risk factors of age, chronic kidney disease, and medications, except for sex difference has significant interaction. CONCLUSIONS This cohort study demonstrated that patients with T2D and discharged with acute liver injury showed significantly higher risks of severe hypoglycemia and mortality within 90 days and 365 days after discharge than patients discharged with other causes.  </p

Details of SNPs found to be predictive of insulin resistance.

<p>Details of SNPs found to be predictive of insulin resistance.</p

Scree plot.

<p>Eigenvalue ratio of 1,000 bootstrapped samples.</p

Cluster statistics based on B-F-W tests.

<p>*Cluster1 and Cluster2 have 177 and 380 individuals, respectively.</p

33 table of LEPR.12 vs PRKCZ.14 (mutual information: 0.0018).

<p>33 table of LEPR.12 vs PRKCZ.14 (mutual information: 0.0018).</p

SVM 10 fold cross-validation: Age, BMI, SNPs and Interaction terms.

<p>SVM 10 fold cross-validation: Age, BMI, SNPs and Interaction terms.</p

Eleven measurements relevant to insulin resistance.

<p>Eleven measurements relevant to insulin resistance.</p

SVM 10 fold cross-validation: Age, BMI and SNPs.

<p>SVM 10 fold cross-validation: Age, BMI and SNPs.</p

SVM 10 fold cross-validation: AGE and BMI.

<p>SVM 10 fold cross-validation: AGE and BMI.</p