간성 당뇨병 = Metabolic & Immunologic Disorders and Liver : Hepatogenous diabetes

다국어 초록 (Multilingual Abstract)

The liver plays a key role in the regulation of glucose metabolism because it is regarded as a critical target organ for insulin and a site for gluconeogenesis. Development of diabetes mellitus (DM) in patients with liver cirrhosis is result of hepatocyte dysfunction. Up to 30% of patients with liver cirrhosis have DM. DM developed as a complication of liver cirrhosis is known as "hepatogenous diabetes"(HD). Insulin resistance in liver and peripheral tissue and hyperinsulinemia is regarded as the pathophysiologic basis of diabetes in liver disease. An dysfunction of the islet β-cells of the pancreas to proper secrete insulin to supplement the impaired insulin action are also contributory factors. Non-alcoholic fatty liver disease (NAFLD), alcoholic liver disease, chronic hepatitis C (CHC) and hemochromatosis are more frequently associated with DM. DM is recognized risk factor for development and progression of chronic liver disease, liver cirrhosis, hepatocellular carcinoma (HCC). This article will review present conception in relation to the epidemiology, pathophysiology, clinical implication and management of hepatogenous diabetes in various chronic liver diseases.