Hagel S, Bruns T, Herrmann A, Stallmach A, Schmidt C
Division of Gastroenterology, Hepatology, and Infectious Diseases, Department of Internal Medicine II, Friedrich-Schiller-University, Jena, Germany.
Z Gastroenterol. 2011 Mar;49(3):331-4. doi: 10.1055/s-0029-1245933. Epub 2011 Mar 9.
In liver cirrhosis an abnormal glucose tolerance correlates with a poor long-term prognosis. The aim of this study was to evaluate whether a disturbed glucose metabolism predicts the short-term prognosis in hospitalized patients with decompensated liver cirrhosis.
Seventy-eight patients with liver cirrhosis were prospectively enrolled. Disturbed glucose metabolism was determined by a 75-g oral glucose tolerance test (OGTT) according to WHO criteria. Differences in survival were assessed by χ (2) test for 30-day mortality and by multivariate Cox proportional hazards analysis for long-term survival.
Impaired glucose tolerance (IGT) was diagnosed in 29 patients (37 %) and diabetes mellitus (DM) in 26 patients (33 %). A pathological OGTT result was a significant negative predictor of a poor 30-day survival compared to NGT (OR 8.6; p=0.03). DM but not IGT was an independent negative predictor of long-term survival (HR=1.89; p=0.04).
Disturbed glucose metabolism in hospitalized patients with decompensated liver cirrhosis is correlated with increased 30-day mortality. OGTT appears to be useful for identifying cirrhotic patients with poor short term prognosis.
