TY - JOUR
T1 - Autoimmune liver diseases and diabetes
T2 - A propensity score matched analysis and a proportional meta-analysis
AU - Jensen, Anne-Sofie H
AU - Winther-Sørensen, Marie
AU - Burisch, Johan
AU - Bergquist, Annika
AU - Ytting, Henriette
AU - Gluud, Lise L
AU - Wewer Albrechtsen, Nicolai J
N1 - © 2023 The Authors. Liver International published by John Wiley & Sons Ltd.
PY - 2023/11
Y1 - 2023/11
N2 - BACKGROUND AND AIMS: Patients with some chronic liver diseases have increased risk of diabetes. Whether this is also the case for patients with autoimmune liver diseases is unknown. The study aimed to calculate risk and worldwide prevalence of diabetes in patients with autoimmune hepatitis (AIH), primary biliary cholangitis (PBC) and primary sclerosing cholangitis (PSC).METHODS: We performed a case-control study using data from the United Kingdom Biobank (UKB) and compared frequency of type 1 diabetes (T1D) and type 2 diabetes (T2D) in AIH and PBC with age-, sex-, BMI- and ethnicity-matched controls. Next, we performed a systematic review and proportional meta-analysis searching PubMed, Embase, Cochrane Library and Web of Science (inception to 1 May 2022 [AIH]; 20 August 2022 [PBC]; 11 November 2022 [PSC]). The pooled prevalence of diabetes was calculated using an inverse method random effects model.RESULTS: Three hundred twenty-eight AIH patients and 345 PBC patients were identified in UKB and risk of T1D and T2D significantly increased compared with matched controls. Our systematic search identified 6914 records including the UKB study. Of these, 77 studies were eligible for inclusion comprising 36 467, 39 924 and 4877 individuals with AIH, PBC and PSC, respectively. The pooled prevalence of T1D was 3.8% (2.6%-5.7%), 1.7% (0.9%-3.1%), 3.1% (1.9%-4.8%) and of T2D 14.8% (11.1%-19.5%), 18.1% (14.6%-22.2%), 6.3% (2.8%-13.3%) in patients with AIH, PBC and PSC, respectively.CONCLUSIONS: Patients with autoimmune liver diseases have increased risk of diabetes. Increased awareness of diabetes risk in patients with autoimmune liver diseases is warranted.
AB - BACKGROUND AND AIMS: Patients with some chronic liver diseases have increased risk of diabetes. Whether this is also the case for patients with autoimmune liver diseases is unknown. The study aimed to calculate risk and worldwide prevalence of diabetes in patients with autoimmune hepatitis (AIH), primary biliary cholangitis (PBC) and primary sclerosing cholangitis (PSC).METHODS: We performed a case-control study using data from the United Kingdom Biobank (UKB) and compared frequency of type 1 diabetes (T1D) and type 2 diabetes (T2D) in AIH and PBC with age-, sex-, BMI- and ethnicity-matched controls. Next, we performed a systematic review and proportional meta-analysis searching PubMed, Embase, Cochrane Library and Web of Science (inception to 1 May 2022 [AIH]; 20 August 2022 [PBC]; 11 November 2022 [PSC]). The pooled prevalence of diabetes was calculated using an inverse method random effects model.RESULTS: Three hundred twenty-eight AIH patients and 345 PBC patients were identified in UKB and risk of T1D and T2D significantly increased compared with matched controls. Our systematic search identified 6914 records including the UKB study. Of these, 77 studies were eligible for inclusion comprising 36 467, 39 924 and 4877 individuals with AIH, PBC and PSC, respectively. The pooled prevalence of T1D was 3.8% (2.6%-5.7%), 1.7% (0.9%-3.1%), 3.1% (1.9%-4.8%) and of T2D 14.8% (11.1%-19.5%), 18.1% (14.6%-22.2%), 6.3% (2.8%-13.3%) in patients with AIH, PBC and PSC, respectively.CONCLUSIONS: Patients with autoimmune liver diseases have increased risk of diabetes. Increased awareness of diabetes risk in patients with autoimmune liver diseases is warranted.
KW - Autoimmune Diseases/complications
KW - Case-Control Studies
KW - Cholangitis, Sclerosing/complications
KW - Diabetes Mellitus, Type 1/complications
KW - Diabetes Mellitus, Type 2/complications
KW - Hepatitis, Autoimmune/complications
KW - Humans
KW - Liver Cirrhosis, Biliary/epidemiology
KW - Liver Diseases/epidemiology
KW - Propensity Score
KW - glucose
KW - overlap syndrome
KW - autoimmune hepatitis
KW - UK Biobank
KW - primary biliary cholangitis
KW - primary sclerosing cholangitis
UR - http://www.scopus.com/inward/record.url?scp=85172108751&partnerID=8YFLogxK
U2 - 10.1111/liv.15720
DO - 10.1111/liv.15720
M3 - Journal article
C2 - 37752719
SN - 1478-3223
VL - 43
SP - 2479
EP - 2491
JO - Liver international : official journal of the International Association for the Study of the Liver
JF - Liver international : official journal of the International Association for the Study of the Liver
IS - 11
ER -