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Effet protecteur de l'hémochromatose vis-à-vis des lésions vasculaires séniles ou diabétiques

par Pirart, Jean ;Barbier, Pierre
Référence Diabetologia, 7, 4, page (227-236)
Publication Publié, 1971-08

Article révisé par les pairs

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Résumé :

1. Signs of common vascular sclerosis and of specific diabetic angiopathy have been sought in 39 cases of proved haemochromatosis with diabetes, in 22 cases of proved haemochromatosis without diabetes, in 84 cases of common cirrhosis with overt diabetes, in 65 cases of common cirrhosis without diabetes, in 65 control subjects and in two groups of patients with common diabetes, each case being carefully paired with a corresponding diabetic either with common cirrhosis or with haemochromatosis as far as sex, age, duration and severity of diabetes as well as body weight are concerned. One out of three cases has been examined at autopsy. - The striking protective effect of haemochromatosis (table 5) was confirmed in five arterial areas (retinae, kidneys, coronary, lower limbs, aorta), and in two areas where diabetic micro-angiopathy (glomeruli and retinae) is typical. This protection is closely related to haemochromatosis, and is not due to the shorter survival of patients with bronze diabetes. Common cirrhosis, despite marked hypocholesterolaemia and better control of the diabetes has but a slight protective effect. Various explanations are suggested, none of them being fully satisfactory. - 2. At least two out of three cases of patients with common cirrhosis have a reduced glucose tolerance. In cirrhosis the values of fasting and of postprandial blood sugar are widely spaced out in an unimodal pattern varying from complete normality to full insulin-dependency. Just as in the general population, the limits of diabetes are quite arbitrary (> 180 mg% two hours after a meal in the present study). According to this definition, diabetes in our series required insulin in only one out of five cases of diabetes associated with cirrhosis, no less in fact than in diabetes without cirrhosis when age and body weight were taken into account. - Clinical features (heredity, evolution, typical vascular complications) do not indicate that diabetes associated with cirrhosis differs markedly from ordinary diabetes of the same severity (glycosuria plus hyperglycaemia > 180 mg% in the fasting state or two hours after a meal). © 1971 Springer-Verlag.