HYPERGLUCAGONEMIA IN CIRRHOTIC-PATIENTS AND ITS RELATIONSHIP TO THE SEVERITY OF CIRRHOSIS AND HEMODYNAMIC VALUES

Plasma glucagon concentrations were measured in 160 cirrhotic patients (Pugh's grade A in 52 patients, Pugh's grade B in 64 patients and Pug h's grade C in 44 patients). These values were compared with plasma gl ucagon concentrations in 57 age and sex-matched healthy subjects. Syst emic and portal haemodynamic measurements, effective renal plasma flow and creatinine clearance were recorded for each patient, Plasma gluca gon levels were significantly increased in cirrhotic patients compared with healthy subjects. In addition, plasma glucagon levels were highe r in cirrbotic patients with ascites than in those without ascites and were increased in relation to the severity of cirrhosis as assessed b y Pugh's score. Multiple linear regression found that only Child-Pugh' s score was estimated to be an independent predictor of hyperglucagona emia in cirrhotic patients. However, in patients with different degree s of oesophageal varices and in patients without oesophageal varices, plasma glucagon concentrations were no different among the different g roups of patients, bur. were still higher than plasma glucagon concent rations in healthy subjects. In contrast, plasma glucagon levels were negatively correlated with mean arterial pressure and systemic vascula r resistance. The results of the present study suggest that impairment of liver function plays, in part, a role in increased plasma glucagon levels observed in patients with cirrhosis. In addition, these data s upport the hypothesis that hyperglucagonaemia may contribute, at least in part, to the pathogenesis of peripheral arterial vasodilatation in cirrhosis with portal hypertension.