Insulin resistance as early sign of hepatic dysfunction in liver cirrhosis

Glucose intolerance characterized by postprandial hyperglycemia and hyperinsulinemia
is commonly seen in patients with liver cirrhosis (LC). The aim of this study
is to clarify the relation between glucose intolerance and disorder of liver function in
patients with LC. The 75 g oral glucose tolerance test (75 g OGTT) and the hyperinsulinemic
euglycemic clamp combined with 0.2 g/kg oral glucose load (HECGL) were conducted
in 61 patients with LC. Based on the results of 75 g OGTT, the 61 patientswith LCwere divided
into groups, 21 (34.4%) patients with normal glucose tolerance (LC-NGT), 12 (19.7%)
patients with impaired glucose tolerance (LC-IGT) and 28 (45.9%) patients with diabetes
mellitus (LC-DM). Fasting plasma glucose (FPG) level was normal in 50 (82.0%) patients
with LC. All patients with LC showed insulin resistance in both peripheral (skeletal and
adipose) and hepatic tissues evaluated by HECGL, although significant correlation between
the degree of glucose intolerance and the severity of hepatic dysfunction was not observed.
Insulin resistance in both liver and peripheral tissues is the early sign in the patients with
LC. This fact indicates that nutritional care from early stages of LC would be necessary in
the patients.