[Behavior of plasma insulin, C-peptide and glucagon in normal subjects and in patients with liver cirrhosis].

Plasma levels of IRI, C-peptide and glucagon were determinated in 19 patients with liver cirrhosis and 9 control subjects after an oral glucose load (OGTT). 9 of the cirrhotics showed chemical diabetes, the remaining 7 cases showed ascites and a normal OGTT. Both groups of cirrhotics showed high IRI and C-peptide values in basal conditions, peaks of these parameters, higher than those observed in the control subjects, were found during the OGTT. The C-peptide/IRI ratio, which was lower than normal both during fasting and after glucose load, presented the lowest value in patients with ascites. In the conditions adopted for this study, glucagon showed higher plasma levels in all the cirrhotics studied than those found in the controls, but the highest levels were found in patients with ascites and with a normal OGTT. It can be concluded that the high levels of insulin found in liver cirrhosis are due to a B-pancreatic hypersecretion (high C-peptide levels) but are also maintained by a decreased hepatic degradation of the hormone (C-peptide/IRI ratio below normal). Hyperglucagonemia is not the chief factor in determining the insulin-resistance observed in liver cirrhosis.