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

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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.

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Authors and Affiliations

  1. Department of Gastroenterology and Hepatology, Nagasaki University Graduate School of Biochemical Sciences, 1-7-1 Sakamoto, Nagasaki, Nagasaki, 852-8501, Japan

    Masafumi Haraguchi, Hisamitsu Miyaaki, Hidetaka Shibata, Takuya Honda, Eisuke Ozawa, Satoshi Miuma, Naota Taura, Fuminao Takeshima & Kazuhiko Nakao

  2. Department of Gastroenterology, Nagasaki Harbor Medical Center City Hospital, 6-39 Shinchi, Nagasaki, Nagasaki, 850-8555, Japan

    Tatsuki Ichikawa

Authors
  1. Masafumi Haraguchi
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  2. Hisamitsu Miyaaki
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  3. Tatsuki Ichikawa
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  4. Hidetaka Shibata
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  5. Takuya Honda
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  6. Eisuke Ozawa
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  7. Satoshi Miuma
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  8. Naota Taura
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  9. Fuminao Takeshima
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  10. Kazuhiko Nakao
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Corresponding author

Correspondence to Hisamitsu Miyaaki.

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Conflict of interest

Dr. Haraguchi, Dr. Miyaaki, Dr. Ichikawa, Dr. Shibata, Dr. Honda, Dr. Ozawa, Dr. Miuma, Dr. Taura, Dr. Takeshima and Dr. Nakao declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. All patients provided informed consent, and our study protocol conformed to the guidelines of the Declaration of Helsinki and was approved by the Nagasaki University Ethics Committee (approval no. 13120201).

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Haraguchi, M., Miyaaki, H., Ichikawa, T. et al. Glucose fluctuations reduce quality of sleep and of life in patients with liver cirrhosis. Hepatol Int 11, 125–131 (2017). https://doi.org/10.1007/s12072-016-9762-1

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  • DOI: https://doi.org/10.1007/s12072-016-9762-1

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