Article Figures & Data
Figures
- Figure 1
- The study protocol’s graphic is presented.
Tables
- Table 1
- Clinical and biochemical characteristics of patients with liver cirrhosis and T2DM.
Parameter Patients with liver cirrhosis & T2DM, N=500 Reference range Age (years) 52.54±10.12 - Gender (male/female) 270(54%)/230(46%) - Duration of diabetes 11±5.13 - Duration of liver cirrhosis 4.5±1.5 - Child-Pugh score 7.5 ± 1.21** 5-15 points Child-Pugh classification 147(29.4%) Class A Class A=5-6 243(48.6%) Class B** Class B=7-9 110(22%) Class C Class C=10-15 FBG (mmol/L) 8.81±1.66 3.89 - 5.50 HbA1c (%) 7.53±1.78 4.3% - 6.0% Blood pressure(systolic/diastolic) 125/80* Systolic: less than 120 mm Hg Diastolic: less than 80 mm Hg LDL-C (mmol/L) 3.81±0.72 2.6 - 4.11 HDL-C (mmol/L) 1.02±0.61 1.04 - 1.6 Total cholesterol (mmol/L) 6.7±1.71 <5.17 Triglycerides (TG) (mmol/L) 3.16±1.19 <1.6 BMI (kg/m2) 26.5±7.51§§ 18.5 - 24.9 AIP = log (TG/HDL-C). 0.4±0.2§ <0.11 hs-CRP(mg/L) 3.4±1.33 <1.0 Albumin (g/dL) 10.4±1.66 30- 50 Total Protein (g/dL) 5.4±1.5 6.3 - 7.9 AST (IU/L) 85.22±10.21 8 - 48 ALT(IU/L) 75.90±11.54 7 - 55 ALP (IU/L) 144±11.26 40 - 129 INR 1.8±0.56 ≤1.1 Total bilirubin (mg/dL) 1.5±0.51 Serum creatinine(mg/dL) 1.9±0.71 0.5- 1.3 mg/dL BUN (mg/dL) 22.5±7.43 6-24 mg/dL CK (U/L) 180±13.65 30- 170 U/L Urine creatinine (mg/dL) 105±16.44 20 – 320 mg/dL Urine Albumin (mg/dL) 45.5±10.12 <30 mg/dl eGFR (mL/min/1.73m2) 55±9.10† 90- 120 mL/min/1.73 m2 Urinary Albumin-to-creatinine ratio (UACR) mg/g 120.5±10.15‡ <30 mg/g Proteinuria (+ve) 35(7%) +ve Hematuria (+ve) 20(4%) +ve Glucosuria (+ve) 90(18%) +ve Glucosuria + Proteinuria (+ve) 125(37%) +ve Proteinuria + Hematuria (+ve) 50(10%) +ve All Glucosuria Hematuria Proteinuria tests (+ve) 320(64%) +ve All Glucosuria Hematuria Proteinuria tests (-ve) 180(36%) -ve Values are presented as mean ± standard deviation, frequency, and percentage (%). Bold is used to indicate values that are either higher or lower than the reference ranges. The reference range values utilized in this study were derived from data obtained from the laboratories of Madinah Hospital, located in the Al Madina Al Munawara, Saudi Arabia.
T2DM: Type 2 diabetes mellitus, FBG: Fasting blood glucose, HbA1c: hemoglobin A1c, HDL-C: high density lipoprotein, and LDL-C: low-density lipoprotein, hs-CRP: high-sensitivity C-reactive protein, BMI: body mass index, AIP: Atherogenic Index of Plasma, AST: aspartate transaminase, ALT: alanine transaminase, ALP: alkaline phosphatase, international normalized ratio, BUN: blood urea nitrogen, CK: creatinine kinase, eGFR: estimated glomerular filtration rate
↵* 120-129 mm Hg systolic and 80 mm Hg diastolic are classified as Elevated.
↵** Child-Pugh score= the severity of liver cirrhosis was considered moderate.
↵§ AIP >0.21, high risk of CVD,
↵§§ BMI (25.0-29.9Kg/m2) overweight.
↵† G3a=eGFR (45-59), there was a mild to moderate decrease.
↵‡ A2= ACR (30–300) there was a moderate increase.
- Table 2
- Evaluation of biomarkers levels in CKD and CVD in patients with LC and type 2 diabetes mellitus (N=500).
Risk factors n (%) Chronic renal disease (CKD) FBG (mmol/L) 7 mmol/L to <7.7 mmol/L 67(13.4%) 7.7 mmol/L to <8.9 mmol/L 241(48.2%)* 8.9 mmol/L to <10 mmol/L 166(33.2%) ≥10 mmol/L 26(5.5%) Blood pressure (systolic/diastolic) <120/80 mm Hg (Normal) 240(48.0%) 120/80 mm Hg (Elevated) 230(46.0%) >120/80 mm Hg (High) 30(6.0%) Serum creatinine (mg/dL) Creatinine 1 mg/dL is normal eGFR 155(31.0%) Creatinine 2 mg/dL is a 50% decreasing in eGFR 255(51.0%)* Creatinine 4 mg/dL is a 70 to 85% decreasing in eGFR 90(18.0%) Creatine 8 mg/dL is a 90 to 95% decreasing in eGFR 0 eGFR stages G1 = 90 (Normal) 55(11.0%) G2 = 60 to 89 (Slightly reduced) 100(20.0%) G3a = 45 to 59 (Moderately to mildly decreased) 255(51.0%)* G3b = 30 to 44 (Moderately to severely reduced) 90(18.0%) G4 = 15 to 29 (Significantly decreased) 0 G5 = 15 (Renal insufficiency) 0 Urinary albumin-to-creatinine ratio mg/g UACR1 <30 (Normal) 140(28.0%) UACR2 = 30 to 300 (Slightly elevated) 300(60.0%)* UACR3 >300 (Moderate increase or severely increased) 60(12.0%) Cardiovascular disease (CVD) LDL-C (mmol/L) <2.6 (Optimal) 344(69.0%) >4.11(Borderline high) 156(31.0%) HDL-C (mmol/L) <1.04 (at risk) 190(38.0%) >1.6 (Desirable) 310(62.0%)* Total cholesterol (mmol/L) <5.17 (Normal) 190(38.0%) 5.17 to 6.18 (Borderline high) 210(42.0%)* >6.21 (High) 100(20.0%) Triglycerides (TG) (mmol/L) <1.6 (Normal) 180(36.0%) 1.6 to 5.6 (Moderately high) 220(440.%)* ≥5.6 mmol/L (Very high) 100(20.0%) BMI (kg/m2) 18.5-25 (Normal) 107(21.0%) 25.0-29.9 (Overweight) 245(49.0%)* >30 (Obese) 150(30.0%) hs-CRP(mg/L) <1.0 (Low risk) 106(21.0%) 1.0-3.0 (Moderate risk) 245(47.0%)* >3.0 (High risk) 150(32.0%) Values are frequency and percentage (%). FBG: fasting blood glucose, HDL-C: high density lipoprotein, LDL-C: low-density lipoprotein, hs-CRP: high-sensitivity C-reactive protein, BMI: body mass index, eGFR: estimated glomerular filtration rate.
↵* P≤0.05 was obtained from the Chi-square test.
- Table 3
- ELogistic regression analysis used to assess the possibility of developing Cardiorenal syndrome (CRS) in patients with T2DM and LC.
Variables Odd ratio (95% CI) P-value Age (years) 30-50 3.13 (1.10–4.31) >0.05 51-70 5.7 (2.11–6.9) 0.05* >71 6.9 (2.12–7.41) 0.04* Gender Females 5.5 (2.41–7.5) 0.04* Males 3.5 (1.16–4.51) >0.05 Elevated blood pressure 5.54 (2.10–6.41) 0.04* High cholesterol 1.12 (0.10–1.31) >0.05 High Triglycerides 5.62 (2.22–7.23) 0.03* BMI= 25.0-29.9 (Overweight) 6.34 (2.10–7.84) 0.03* Elevated UACR 1.12 (0.10–1.31) >0.05 Elevated hs-CRP 5.29 (2.12–7.56) 0.04* The statistically significant data are indicated in bold, p≤0.05 or 0.001. Logistic regression analysis,
↵* P<0.05, CI: confidence interval. BMI: body mass index, UACR: Albumin-to-creatinine ratio
- Table 4
- The incidence of developing CVD or CKD, or the co-occurrence of both conditions (CRS) in individuals diagnosed with T2DM and LC based on biomarker levels (N=500).
The prevalence of patients at high risk of having CVD 108(21.6%) The prevalence of patients at high risk of having CKD 100(20%) The prevalence of patients at high risk of having CRS 91(18.2%) Total 299(59.8%) Frequency and percentage (%). The patient frequency was determined by assessing the presence of risk factors associated with the development of CVD, CKD, or (CRS). CVD: cardiovascular disease, CKD: chronic kidney disease, CRS: cardiorenal syndrome, T2DM: type 2 diabetes mellitus
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