Insulin resistance and liver cirrhosis

ABSTRACT

This work was performed on 15 patients with liver cirrhosis or fibrosis and 15 healthy control subjects to study glucose utilization and insulin level using the intravenous glucose tolerance test [IVGTT]. The results of glucose and insulin were illustrated on a curve, then glucose area and insulin area under the curve were calculated. In addition, insulin area/glucose area ratio [insulinogenic index] and insulin stimulating activity [ISA] were estimated to evaluate B-cell response to hyperglycemia. Also, the Kg- value was estimated to assess the rate of glucose assimilation per minute. The results obtained showed that the rate of glucose utilization in cirrhosis [Kg-value] was significantly decreased compared to controls. At the same time, the B-cell function was not affected in cirrhosis, as concluded from the insignificant change in insulinogenic index and ISA compared to healthy controls. Also, there was fasting hyperinsulinemia associated with fasting euglycemia indicating insulin resistance. It has been concluded that the cause of hyperinsulinemia, glucose intolerance and consequently insulin resistance in cirrhosis is defective peripheral tissue response to insulin, whether the defect is in the receptor binding or post- receptor defect, this remains to be investigated