Impaired Oral Glucose Tolerance Test and Diabetes mellitus Predict Short Term Prognosis of Patients with Liver Cirrhosis

Objective: The aim of this study was to evaluate whether oral glucose tolerance test (OGTT) and manifest diabetes mellitus are useful in prediction of short term prognosis of patients with liver cirrhosis. Methods: Seventy-nine patients with liver cirrhosis of different etiologies were enrolled in a prospective cohort study. Diabetes mellitus (DM) and impaired glucose tolerance (IGT), which was diagnosed by a 75-g OGTT, were defined according to current World Health Organization criteria. The relationship of clinical variables to the cirrhosis-related prognosis was investigated using regression analysis. Results: IGT was diagnosed in 29 subjects (37%), DM in 27 subjects (34%), and normal glucose tolerance (NGT) in 23 subjects (29%). 3-month survival analysis showed that compared to normal glucose tolerance, disturbed metabolic status (IGT and DM) is a predictor of poor survival (odds-ratio 4,3), as well as liver cirrhosis classified as stadium Child-Pugh C compared to patients with liver cirrhosis stadium Child-Pugh A and B (odds ratio 3,9). Multiple regression analysis yielded Child-Pugh C and disturbed metabolic status (IGT and DM) as the most powerful negative predictors of short-time survival. Conclusions: IGT and DM appear to be useful for evaluating the prognosis of cirrhotic patients not only in long-term survival, as it was shown by Nishida et al.(1) and Bianchi et al. (2) before, but also in evaluating short-term prognosis.

Literatur: (1) Nishida T. et al., Oral Glucose Tolerance Test Predicts Prognosis of Patients with Liver Cirrhosis, Am J Gastroenterol. 2006 Jan;101(1):70-5. (2) Bianchi G. et al., Prognostic significance of diabetes in patients with cirrhosis, Hepatology. 1994 Jul;20(1 Pt 1):119-25.

cirrhosis - diabetes - oral glucose tolerance test - prognosis