Glucose fluctuations reduce quality of sleep and of life in patients with liver cirrhosis.

Abstract

BACKGROUND:

Sleep disturbance and decreased health-related quality of life (HRQOL) are significant complaints in patients with liver cirrhosis. Although the etiology of these complications is unclear, we propose that glucose intolerance may be a predisposing factor. Therefore, our aim was to investigate the relationship between glucose intolerance and these complications.

METHODS:

We assessed continuous glucose monitoring in 43 patients with chronic liver disease. Among these patients, 36 completed the Pittsburgh Sleep Quality Index (PSQI), the 36-Item Short-form Health Survey (SF-36), and the Neuropsychological Test (NPT). We also assessed the change in glucose fluctuations between preoperative periods and 1 year after liver transplantation in 13 patients.

RESULTS:

Standard deviation (SD) of blood glucose was 24.15 ± 13.52. SD values correlated to glucose metabolism measures, including HbA1c and glycoalbumin. SD values also correlated to markers of liver fibrosis, including type IV collagen. Twenty-one patients (58.3 %) were classified as "poor" sleepers, with a global PSQI score ≥6. Glucose fluctuations correlated with the global PSQI score (r = 0.456, p = 0.008) and the SF-36 score (r = 0.434, p = 0.013). Multivariate regression analysis identified SD values as an independent risk factor for sleep disturbance (r = 0.12, p = 0.039) and decreased HRQOL (r = -0.32, p = 0.024). SD values did not correlate with the NPT. SD values were also improved in 11 (84.6 %) patients 1 year after liver transplantation.

CONCLUSION:

Abnormal glucose fluctuations are a risk factor for sleep disturbance and decrease of HRQOL in patients with cirrhosis.

• Authors: Masafumi Haraguchi, Hisamitsu Miyaaki, Tatsuki Ichikawa, Hidetaka Shibata, Takuya Honda, Eisuke Ozawa, Satoshi Miuma, Naota Taura, Fuminao Takeshima, Kazuhiko Nakao
• Journal: Hepatology international (Hepatol Int) Vol. 11 Issue 1 Pg. 125-131 (Jan 2017) ISSN: 1936-0541 [Electronic] United States
• PMID: 27624504 (Publication Type: Journal Article)

Chemical References

• Blood Glucose
• Glycated Hemoglobin A
• Glycation End Products, Advanced
• Serum Albumin
• hemoglobin A1c protein, human
• Glycated Serum Albumin

Topics

• Adult
• Aged
• Blood Glucose (metabolism)
• Female
• Glycated Hemoglobin (metabolism)
• Glycation End Products, Advanced
• Humans
• Liver Cirrhosis (blood, metabolism, physiopathology, therapy)
• Male
• Middle Aged
• Quality of Life
• Regression Analysis
• Risk Factors
• Serum Albumin (metabolism)
• Sleep Wake Disorders (blood, metabolism, physiopathology)
• Glycated Serum Albumin