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Am J Gastroenterol. 2006 Jan;101(1):70-5.
Oral glucose tolerance test predicts prognosis of patients with liver cirrhosis.
Nishida T1, Tsuji S, Tsujii M, Arimitsu S, Haruna Y, Imano E, Suzuki M, Kanda T, Kawano
S, Hiramatsu N, Hayashi N, Hori M.
Author information
Abstract
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.
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Am J Gastroenterol. 2006 Jan; 101 (1): 70-5.
Oral tes toleransi glukosa memprediksi prognosis pasien dengan sirosis hati.
Nishida T1, Tsuji S, Tsujii M, Arimitsu S, Haruna Y, Imano E, Suzuki M, Kanda T, Kawano S,
Hiramatsu N, Hayashi N, Hori M.
informasi penulis
Abstrak
TUJUAN:
Tujuan dari penelitian ini adalah untuk mengevaluasi apakah lisan tes toleransi glukosa (OGTT)
berguna dalam mengevaluasi prognosis pasien dengan sirosis hati.
METODE:
Lima puluh enam pasien sirosis hati yang terdaftar dalam studi kohort prospektif. Dalam semua
kasus, toleransi glukosa didiagnosis oleh 75-g OGTT menurut Organisasi Kesehatan Dunia
(WHO) kriteria. Hubungan variabel klinis untuk prognosis terkait sirosis diselidiki menggunakan
model regresi univariat dan multivariat.
HASIL:
Diabetes mellitus (DM) didiagnosis pada 21 subyek (38%), gangguan toleransi glukosa (IGT) di
13 mata pelajaran (23%), dan toleransi glukosa normal (NGT) di 22 mata pelajaran (39%)
menggunakan OGTT. Tingkat kelangsungan hidup kumulatif pasien dengan sirosis hati dan NGT
adalah 94,7% pada 5 tahun; sirosis hati dan IGT, 68,8% pada 5 tahun; sirosis hati dan DM,
56,6% pada 5 tahun. Tingkat kelangsungan hidup pasien dengan sirosis hati dan DM secara
signifikan berbeda dari orang-orang dengan NGT. analisis univariat menunjukkan bahwa
albumin serum, bilirubin total, aktivitas protrombin, skor Child-Pugh, dan intoleransi glukosa
merupakan faktor prognostik yang sangat signifikan. analisis regresi berganda menghasilkan
albumin dan DM sebagai prediktor negatif independen yang paling kuat bertahan hidup.
KESIMPULAN:
OGTT tampaknya berguna untuk mengevaluasi prognosis pasien sirosis.
Funding Information
Abstract
Alterations in carbohydrate metabolism are frequently observed in cirrhosis, and approximately
15% to 30% of patients have overt diabetes. In a retrospective and prospective study in cirrhosis,
we analyzed the prognostic significance of diabetes, which was defined as the presence of
hyperglycemia and overt glycosuria that in most cases required dietary restrictions or active
treatment. The clinical records of all patients with cirrhosis admitted to our department for the
period 1980 to 1985 were reviewed in 1985 and 1986, and surviving patients were prospectively
followed up until December 1991. Final status could be obtained in 354 (98 with diabetes) of
382 eligible patients; 110 were alive at the end of follow-up. Prognostic factors were identified
by Kaplan-Meier analysis, followed by Cox's stepwise regression. The model identified, in
sequence, albumin, ascites, age, encephalopathy, bilirubin, diabetes, and platelets as prognostic
factors. The larger mortality rate in patients with diabetes was not due to complications of
diabetes but to an increased risk of hepatocellular failure. Diabetes was no longer a risk factor as
a covariate in a subgroup of 271 patients when varices were added but was again significant
when patients who died of gastrointestinal bleeding were excluded. The presence of diabetes,
clinically detectable and often requiring adequate treatment, is a risk factor for long-term
survival in cirrhosis. (Hepatology 1994;20:119125.)