title: The prevalence and clinical characteristics of glucose metabolism disorders in patients with liver cirrhosis. A prospective study.
abstract: OBJECTIVE
  To define the prevalence and clinical characteristics of glucose metabolism disorders (GMD) in patients with compensated liver cirrhosis (LC).
  
  
  METHODS
  Fasting plasma glucose (FPG) levels were measured to 130 patients with clinically stable LC. Oral glucose tolerance tests (OGTT) and fasting plasma insulin determinations were performed to patients with normal FPG. Insulin resistance (IR) was calculated with HOMA2-IR index. GMD were classified according to FPG and OGTT tests results and to the chronologic relation between diagnosis of diabetes mellitus (DM) and LC as follows: type-2 DM (T2DM), hepatogenous diabetes (HD) and impaired glucose tolerance. Patients from all groups were compared.
  
  
  RESULTS
  The prevalence of GMD were as follows: T2DM in 25 patients (19.2%, 95% CI 12.5-25.9), HD in 28 (21.5%, 95% CI 14.5-28.5) and IGT in 36 (38.5%, 95% CI 30.1-46.7). The total of patients with GMD was 79.2% (95% CI 72.3-86.1). In 41% of cases GMD were subclinical and 48.7% of patients had IR. Patients with T2DM had a higher number of variables with significant differences compared with the other groups (more marked compared to the patients without GMD). The only differences between the patients with T2DM and HD were hypercreatininemia: 1.14 ± 0.53 vs. 0.84 ± 0.22 mg/dL (p = 0.005) and family history of DM: 8 (32%) vs. 2 (7%) (p = 0.02).
  
  
  CONCLUSIONS
  Almost 80% of patients with compensated LC had GMD. Half of them were subclinical. The patients with T2DM had marked clinical differences compared to patients from the other groups, particularly renal impairment.
authors.affiliation: Gastroenterology Service and Department of Internal Medicine, University Hospital Dr. José E. González and Medical School, Universidad Autónoma de Nuevo León, Monterrey, Mexico. digarciacompean@prodigy.net.mx
authors.forename: Diego
authors.initials: D
authors.lastname: García-Compeán
authors.forename: Joel Omar
authors.initials: JO
authors.lastname: Jáquez-Quintana
authors.forename: Fernando Javier
authors.initials: FJ
authors.lastname: Lavalle-González
authors.forename: Erick
authors.initials: E
authors.lastname: Reyes-Cabello
authors.forename: José Alberto
authors.initials: JA
authors.lastname: González-González
authors.forename: Linda Elsa
authors.initials: LE
authors.lastname: Muñoz-Espinosa
authors.forename: Genaro
authors.initials: G
authors.lastname: Vázquez-Elizondo
authors.forename: Jesús Zacarías
authors.initials: JZ
authors.lastname: Villarreal-Pérez
authors.forename: Héctor J
authors.initials: HJ
authors.lastname: Maldonado-Garza
mesh_terms: D000328:Adult; D000368:Aged; D001786:Blood Glucose; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000453:epidemiology; D005260:Female; D018149:Glucose Intolerance / Q000150:complications / Q000453:epidemiology; D044882:Glucose Metabolism Disorders / Q000150:complications / Q000453:epidemiology / Q000503:physiopathology; D005951:Glucose Tolerance Test; D006801:Humans; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance; D007668:Kidney / Q000503:physiopathology; D008103:Liver Cirrhosis / Q000150:complications / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies
chemical_list: D001786:Blood Glucose; D007328:Insulin