Oral Glucose Tolerance Test Predicts Prognosis of Patients with Liver Cirrhosis

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The American Journal of Gastroenterology

Volume 101 Page 70 - January 2006

doi:10.1111/j.1572-0241.2005.00307.x

Volume 101 Issue 1

Oral Glucose Tolerance Test Predicts Prognosis of Patients with Liver

Cirrhosis

Tsutomu Nishida, M.D.1,2, Shingo Tsuji, M.D., Ph.D.1, Masahiko Tsujii, M.D.,

Ph.D.1, Shoko Arimitsu, M.D.2, Yoshimichi Haruna, M.D., Ph.D.2, Eiichi

Imano, M.D., Ph.D.2, Masaaki Suzuki, M.D., Ph.D.2, Tsutomu Kanda, M.D.,

Ph.D.2, Sunao Kawano, M.D., Ph.D.3, Naoki Hiramatsu, M.D., Ph.D.4, Norio

Hayashi, M.D., Ph.D.4, andMasatsugu Hori, M.D., Ph.D.1

OBJECTIVE: The aim of this study was to evaluate whether oral glucose

tolerance test (OGTT) was useful in evaluating the prognosis of patients

with liver cirrhosis.

METHODS: Fifty-six patients with liver cirrhosis were enrolled in a

prospective cohort study. In all cases, glucose tolerance was diagnosed by a

75-g OGTT according to World Health Organization (WHO) criteria. The

relationship of clinical variables to the cirrhosis-related prognosis was

investigated using univariate and multivariate regression models.

RESULTS: Diabetes mellitus (DM) was diagnosed in 21 subjects (38%),

impaired glucose tolerance (IGT) in 13 subjects (23%), and normal glucose

tolerance (NGT) in 22 subjects (39%) using OGTT. The cumulative survival

rates of patients with liver cirrhosis and NGT were 94.7% at 5 yr; liver

cirrhosis and IGT, 68.8% at 5 yr; liver cirrhosis and DM, 56.6% at 5 yr. The

survival rates of patients with liver cirrhosis and DM significantly

differed from those with NGT. Univariate analysis demonstrated that serum

albumin, total bilirubin, prothrombin activity, Child-Pugh scores, and

glucose intolerance were highly significant prognostic factors. Multiple

regression analysis yielded albumin and DM as the most powerful independent

negative predictors of survival.

CONCLUSIONS: OGTT appears to be useful for evaluating the prognosis of

cirrhotic patients.

(Am J Gastroenterol 2005;100:1–6)

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