INCIDENCE OF ALTERED GLUCOSE-TOLERANCE IN LIVER-CIRRHOSIS

Even though the association between liver cirrhosis and glucose tolera nce alterations has been well documented, no data are available on the incidence of this association. In this paper we firstly report the re sults of a 4-year prospective longitudinal study performed on well-com pensated cirrhotic patients with a normal glucose tolerance, in order to evaluate the incidence of glucose tolerance alterations with respec t to liver efficiency during the time. The incidence of a diabetic res ponse to a standard OGTT was 4.4% after a 1-year and 21.2% after a 4-y ear follow-up in stable cirrhotics. These figures are significantly hi gher than in the general population of our country. This large inciden ce was even significantly higher in cirrhotics with worsening liver ef ficiency at the end of the study (35.3%, P < 0.0001). Sex, family hist ory of diabetes, alcoholic aetiology of the cirrhosis, and increment o f portal hypertension do not seem to have any significant influence on the frequency of altered glucose tolerance. Therefore, we propose tha t liver cirrhosis and its worsening play a primary role as diabetogeni c risk factors.