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. 2021 Jan 5;22(1):463. doi: 10.3390/ijms22010463

Table 1.

Similarities and differences between hepatic encephalopathy and diabetic encephalopathy.

Similarities between Hepatic Encephalopathy and Diabetic Encephalopathy Differences between Hepatic Encephalopathy and Diabetic Encephalopathy
Brain vasculature
  • Increased BBB permeability

  • BBB breakdown

  • Increased level of water channel molecule, AQP-4

  • Decreased levels of tight junction molecules, such as ZO-1 and occluding

  • Changes in BBB integrity and permeability by increased bile acid

  • Brain edema induced by hyperammonaemia in HE

Glial cells
  • Abnormal astrocyte function in glutamine-glutamate homeostasis

  • Astrocyte swelling

  • Microglial activation and secretion of inflammatory cytokines

  • Levels of GFAP in HE and DE

  • Astrocyte dysfunction in ammonia detoxification in HE

  • Hyperammonaemia-driven neuroinflammation in HE

Neurotransmitters
  • Impairment of neuronal function

  • Changes in GABA, glutamate, choline levels

  • Changes in serotonin and dopamine levels in HE and DE

Glucose metabolism
  • Insulin resistance

  • Impairment of glucose metabolism, including glucose uptake

  • Protective effect after inhibition of SGLT1 and/or SGLT2

  • The level of GLUT1 in HE and DE

Cognitive function
  • Learning and memory impairment

  • Disrupted attention

  • Neuropsychological dysfunction (Anxiety and depression)

  • Progressive and mild cognitive dysfunction in DE

  • Dynamic and reversible cognitive dysfunction in HE

etc.
  • Bacterial infection (Hepatitis) in HE

  • Pancreatic beta cell loss in DE