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KMID : 0354719900140020223
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Journal of Korean Diabetes Association
1990 Volume.14 No. 2 p.223 ~ p.227
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Abnormal Glucose Tolerance in Patients with Chronic Hepatic Diseases
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金景中/Kim, Gyoung Jung
朴昶榮/朴永萬/朴鈴徹/李晩浩/李祥鍾/Park, Chang Young/Jhoo, Young Man/Park, Young Chul/Lee, Man Ho/Lee, Sang Jong
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Abstract
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Galambo reported that it is common to see abnormal goucose tolerance with normal fasting blood sugar level in patients with cirrhosis of liver.
To monitor metabolic control of established diabetic patients, glycosylated hemoglobin and/or fructosamine .have used recently. It generally detects well-marked hyperglycemta but is believed to be not sensitive enough to detect minor abnormalities of glucose tolerance. However, we could not find any report in the literature that glycosylated hemoglobin and fructosamine used in patients with chronic hepatic diseases. The purpose of this study was to assess the prevalence of IGT and diabetes mellitus in patients who had chronic liver diseases without any other known diabetognic risk factor and HbAIC levels in patients with chronic liver diseases and various changes of glucose metabolism. We studied 66 patients with hepatic diseases including 32 cirrhosis and 34 chronic active hepatitis, who were admitted to Internal Medicine service at this hospital from October 1988 to December 1989, and control group of 30 normal subjects.
The prevalence of impaired glucose tolerance and diabetes mellitus defined by National Diabetes Data Group Criteria, glycosylated hemoglobin level were evaluated in a series of consecutive patients who had chronic active hepatitis or cirrhosis of the liver in the absence of any known diabetogenic risk factors and who had normal fasting glucose levels. Based on oral glucose tolerance test, the prevalence of IGT (18%) and diabetes mellitus (25%) in patients with cirrhosis of the liver was significantly higher than that observed in normal controls (0%) and patients with chronic active hepatitis (0%). In contrast, both concentrations of HbAlc were not significantly different in cirrhotic patients with or without abnormal glucose tolerance, as compared with normal controls and chronic active hepatitis.
We believe that both HbAIC are unsatisfactory test in the detection of altered glucose tolerance in patients with cirrhosis, and cirrhosis of liver may be represented itself a risk factor for the development of abnormal glucose metabolism. Therefore, routine oral glucose tolerance test is warranted in these patients. We propose more detailed and larger scale study to conclude this hypothesis.
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KEYWORD
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