Skip to main content

Main menu

  • Home
  • COVID-19
    • Articles & podcasts
    • Blog posts
    • Collection
    • News
  • Content
    • Current issue
    • Past issues
    • Early releases
    • Collections
    • Sections
    • Blog
    • Infographics & illustrations
    • Podcasts
    • Classified ads
  • Authors
    • Overview for authors
    • Submission guidelines
    • Submit a manuscript
    • Forms
    • Editorial process
    • Editorial policies
    • Peer review process
    • Publication fees
    • Reprint requests
  • CMA Members
    • Overview for members
    • Earn CPD Credits
    • Print copies of CMAJ
    • Career Ad Discount
  • Subscribers
    • General information
    • View prices
  • Alerts
    • Email alerts
    • RSS
  • JAMC
    • À propos
    • Numéro en cours
    • Archives
    • Sections
    • Abonnement
    • Alertes
  • CMAJ JOURNALS
    • CMAJ Open
    • CJS
    • JAMC
    • JPN

User menu

Search

  • Advanced search
CMAJ
  • CMAJ JOURNALS
    • CMAJ Open
    • CJS
    • JAMC
    • JPN
CMAJ

Advanced Search

  • Home
  • COVID-19
    • Articles & podcasts
    • Blog posts
    • Collection
    • News
  • Content
    • Current issue
    • Past issues
    • Early releases
    • Collections
    • Sections
    • Blog
    • Infographics & illustrations
    • Podcasts
    • Classified ads
  • Authors
    • Overview for authors
    • Submission guidelines
    • Submit a manuscript
    • Forms
    • Editorial process
    • Editorial policies
    • Peer review process
    • Publication fees
    • Reprint requests
  • CMA Members
    • Overview for members
    • Earn CPD Credits
    • Print copies of CMAJ
    • Career Ad Discount
  • Subscribers
    • General information
    • View prices
  • Alerts
    • Email alerts
    • RSS
  • JAMC
    • À propos
    • Numéro en cours
    • Archives
    • Sections
    • Abonnement
    • Alertes
  • Visit CMAJ on Facebook
  • Follow CMAJ on Twitter
  • Follow CMAJ on Pinterest
  • Follow CMAJ on Youtube
  • Follow CMAJ on Instagram
Letter

Diabetes mellitis: risk factor for advanced liver disease

Ferhan Siddiqi, Lindsay Carter and Kevork M. Peltekian
CMAJ March 22, 2011 183 (5) 586; DOI: https://doi.org/10.1503/cmaj.111-2029
Ferhan Siddiqi
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Lindsay Carter
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Kevork M. Peltekian
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • Article
  • Responses
  • Metrics
  • PDF
Loading

The study by Porepa and colleagues confirms something most hepatologists have always known: diabetes mellitus is a risk factor for advanced liver disease.1 I congratulate the authors for taking on this methodologically difficult task, but they missed a few opportunities for addtional knowledge translation.

Hemochromatosis, a genetic disease of iron overload that, if not recognized, leads to diabetes and cirrhosis, should have been in the exclusion and censoring criteria. After all, the prevalence of hemochromatosis may be as high as 5/1000 people of northern European descent.2

In addition, hepatocellular carcinoma, a known complication of cirrhosis, should have been included in the list of serious liver disease outcomes as a surrogate marker for cirrhosis because ICD (International Classification of Diseases) coding of liver disease and its complications is not always comprehensive.3 Some patients with primary liver cancer would have been included in the analysis because either cirrhosis was mentioned in the discharge abstract database or the patient underwent liver transplantation for hepatocellular carcinoma.

Obesity, diabetes and metabolic syndrome are risk factors for nonalcoholic fatty liver disease and advanced fibrosis (metabolic syndrome confers an odds ratio of 3.5 for advanced fibrosis).4 In addtion to the risk of serious liver disease in patients with diabetes alone, hypertension alone, dyslipidemia alone and obesity alone, it would have been helpful to identify, from this large population database, the additional cumulative risk for serious liver disease in patients with metabolic syndrome.

References

  1. ↵
    1. Porepa L,
    2. Ray JG,
    3. Sanchez-Romeu P,
    4. et al
    . Newly diagnosed diabetes mellitus as a risk factor for serious liver disease. CMAJ 2010;182:E526–31.
    OpenUrlAbstract/FREE Full Text
  2. ↵
    1. McLaren GD,
    2. McLaren CE,
    3. Adams PC,
    4. et al
    . Clinical manifestations of hemochromatosis in HFE C282Y homozygotes identified by screening. Can J Gastroenterol 2008;22:923–30.
    OpenUrlPubMed
  3. ↵
    1. Desai S,
    2. Peltekian KM
    . Canadian mortality rates for liver disease: taking a closer look at ICD coding. Can J Public Health 2004;95:1098–200.
    OpenUrl
  4. ↵
    1. Adams LA,
    2. Angulo P,
    3. Lindor KD
    . Nonalcoholic fatty liver disease. CMAJ 2005;172:899–905.
    OpenUrlAbstract/FREE Full Text
PreviousNext
Back to top

In this issue

Canadian Medical Association Journal: 183 (5)
CMAJ
Vol. 183, Issue 5
22 Mar 2011
  • Table of Contents
  • Index by author

Article tools

Respond to this article
Print
Download PDF
Article Alerts
To sign up for email alerts or to access your current email alerts, enter your email address below:
Email Article

Thank you for your interest in spreading the word on CMAJ.

NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

Enter multiple addresses on separate lines or separate them with commas.
Diabetes mellitis: risk factor for advanced liver disease
(Your Name) has sent you a message from CMAJ
(Your Name) thought you would like to see the CMAJ web site.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
Citation Tools
Diabetes mellitis: risk factor for advanced liver disease
Ferhan Siddiqi, Lindsay Carter, Kevork M. Peltekian
CMAJ Mar 2011, 183 (5) 586; DOI: 10.1503/cmaj.111-2029

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
‍ Request Permissions
Share
Diabetes mellitis: risk factor for advanced liver disease
Ferhan Siddiqi, Lindsay Carter, Kevork M. Peltekian
CMAJ Mar 2011, 183 (5) 586; DOI: 10.1503/cmaj.111-2029
Digg logo Reddit logo Twitter logo Facebook logo Google logo Mendeley logo
  • Tweet Widget
  • Facebook Like
  • Google Plus One

Jump to section

  • Article
    • References
  • Responses
  • Metrics
  • PDF

Related Articles

  • No related articles found.
  • PubMed
  • Google Scholar

Cited By...

  • No citing articles found.
  • Google Scholar

More in this TOC Section

  • Editor’s response
  • Oral contraceptives and risk of gallbladder disease
  • Oral contraceptives and risk of gallbladder disease
Show more Letter

Similar Articles

Content

  • Current issue
  • Past issues
  • Collections
  • Sections
  • Blog
  • Podcasts
  • Alerts
  • RSS
  • Early releases

Information for

  • Advertisers
  • Authors
  • Reviewers
  • CMA Members
  • Media
  • Reprint requests
  • Subscribers

About

  • General Information
  • Journal staff
  • Editorial Board
  • Governance Council
  • Journal Oversight
  • Careers
  • Contact
  • Copyright and Permissions

Copyright 2021, Joule Inc. or its licensors. All rights reserved. ISSN 1488-2329 (e) 0820-3946 (p)

All editorial matter in CMAJ represents the opinions of the authors and not necessarily those of the Canadian Medical Association or its subsidiaries.

Powered by HighWire