ABSTRACT
Human liver cirrhosis is commonly associated with increased fasting and glucose induced insulin concetrations. The main cause of impaired glucose metabolism in chronic liver disease is a reduced insulin action. Patients with chronic liver disease complicated with human hepatocellular carcinoma [HHC] frequently have impaired glucose metabolism. Aim: To investigate the effect of augmentation of postprandial hyperinsulinaemia on the growth of hepatocellular carcinoma. Patients and methods: The growth rate of 60 small hepatocellular carcinomas [diameter 140 days, n=30]. Fasting plasma insulin concentration and area under the plasma curve [AUCins] of oral glucose tolerance test [10.3[6.3] mirco U/ml and 265 [159] mirco U/ml/h, respectively; [mean [SD] in the rapid growth group were significantly higher than those in the slow growth group [7.7[4.5] mirco U/ml/h and 153 [145] mirco U/ml/h], respectively] [p= 0.031, and 0.0005], respectively. In contrast, Fasting plasma glucose concentration and area under the plasma glucose curve [AUCglu] in the rapid growth group were significantly lower than those in the slow growth group [p=0.0002 and p=0.001, respectively]. Initial tumor size was significantly higher in rapid growth than in the slow growth with p=0.01. Univariate and multivariate analyses of logisitic regression models demonstrated that AUCins was a significant factor contributing to the growth rate of HCC [p=0.001 and p=0.015, respectively]. Conclusions: The real time ultrasonography appears to offer a simple, safe, and noninvasive method of monitoring the growth rate of hepatocellular carcinoma. The postprandial hyperinsulinaemia is significantly correlated with the rapid growth of human hepatocellular carcinoma; accordingly octreotide[long acting somatostatin analogue] can be used in the treatment of inoperable hepatocellular carcinoma