Oral glucose tolerance test predicts prognosis of patients with liver cirrhosis.
OBJECTIVE
The aim of this study was to evaluate whether oral glucose tolerance test (OGTT) was useful in evaluating the prognosis of patients with liver cirrhosis.


METHODS
Fifty-six patients with liver cirrhosis were enrolled in a prospective cohort study. In all cases, glucose tolerance was diagnosed by a 75-g OGTT according to World Health Organization (WHO) criteria. The relationship of clinical variables to the cirrhosis-related prognosis was investigated using univariate and multivariate regression models.


RESULTS
Diabetes mellitus (DM) was diagnosed in 21 subjects (38%), impaired glucose tolerance (IGT) in 13 subjects (23%), and normal glucose tolerance (NGT) in 22 subjects (39%) using OGTT. The cumulative survival rates of patients with liver cirrhosis and NGT were 94.7% at 5 yr; liver cirrhosis and IGT, 68.8% at 5 yr; liver cirrhosis and DM, 56.6% at 5 yr. The survival rates of patients with liver cirrhosis and DM significantly differed from those with NGT. Univariate analysis demonstrated that serum albumin, total bilirubin, prothrombin activity, Child-Pugh scores, and glucose intolerance were highly significant prognostic factors. Multiple regression analysis yielded albumin and DM as the most powerful independent negative predictors of survival.


CONCLUSIONS
OGTT appears to be useful for evaluating the prognosis of cirrhotic patients.
Nishida
Tsutomu
T
Department of Internal Medicine and Therapeutics, Osaka University Graduate School of Medicine, Suita, Osaka, Japan.
Tsuji
Shingo
S
Tsujii
Masahiko
M
Arimitsu
Shoko
S
Haruna
Yoshimichi
Y
Imano
Eiichi
E
Suzuki
Masaaki
M
Kanda
Tsutomu
T
Kawano
Sunao
S
Hiramatsu
Naoki
N
Hayashi
Norio
N
Hori
Masatsugu
M
D000368:Aged; D000704:Analysis of Variance; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000032:analysis; D015331:Cohort Studies; D018450:Disease Progression; D005260:Female; D005951:Glucose Tolerance Test; D006801:Humans; D008103:Liver Cirrhosis / Q000401:mortality* / Q000473:pathology* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011336:Probability; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D015996:Survival Rate
D015415:Biomarkers; D001786:Blood Glucose