Comparison of Glucose Intolerance according to Severity of Chronic Liver Diseases

Lee, Seung Ok; Ahn, Heok Soo; Lee, Soo Teik; Kim, Dae Ghon; Ahn, Deuk Soo

Abstract

BACKGROUND/AIMS: We investigated correlation between the severity of liver disease and glucose intolerance. Additionally, we compared the rate of glucose intolerance between the patients with pure liver cirrhosis and non-insulin-dependent diabetes mellitus (NIDDM) preceded cirrhosis.
METHODS
We classified eighty patients with chronic liver disease from L1 to L3 according to the severity liver injury by biochemical factors and the patients with NIDDM preceded cirrhosis were classified into L3-D group. We measured HbA1C, serum insulin and C-peptide and carried out 100 g oraglucose tolerance tests (OGTT).
RESULTS
The rate of glucose intolerance was 35% in L2 group and 89% in L3 group, and the rate of diabetic range was 5% and 41%, respectively. In L3 group, fastin blood sugar and HbA1C were in normal range, but the increment of serum insulin, C-peptide and blood glucose in OGTT were higher than in L1 or L2 group. In L3-D group, fasting blood sugar and HbA1C were higher than normal and more increment of blood glucose after oral glucose load was observed than in L3. Significant difference in insulin or C-peptide level was not observed between L3 and L3-D.
CONCLUSIONS
Glucose intolerance appears to be proportional to the severity of live injury in chronic liver disease. It suggests that OGTT can be an indicator of hepatic injury. We should carefully interpret the glucose intolerance in liver cirrhosis because it shows different pattern from NIDDM preceded cirrhosis.