Background: Glucose intolerance occurs frequently in patients with liver cirrhosis. However, few studies have assessed its prognostic value in patients with liver cirrhosis. Aim: To evaluate the importance of oral glucose tolerance test (OGTT), insulin-like growth factor-I (IGF-I) and serum transferrin (TRF) in prediction of disease outcome in patients with posthepatitic liver cirrhosis . Methods: Seventy-four patients with posthepatitic liver cirrhosis and 30 healthy controls were recruited. All participants were subjected to OGTT and estimation of serum IGF-I and TRF levels at the start of the study. All patients were followed up for one year. Results: OGTT revealed that 28 patients (38%) had normal glucose tolerance (NGT), 20 patients (27%) had impaired glucose tolerance (IGT), while 26 patients (35%) had frank diabetes mellitus (DM). A significant decrease of serum IGF-I was found in patients (in all Child classes) compared to the controls. Mean serum transferrin didn't differ between patients and controls, but it was significantly higher in Child C patients compared to Child A and B. All diabetic patients developed complications during their follow up. Multiple logistic regression analysis revealed that Child-Pugh score, serum albumin and the presence of diabetes mellitus are the most powerful independent predictors of complications. Conclusion: IGF-I decreases early in liver cirrhosis and may indicate early synthetic dysfunction. OGTT should be combined with Child-Pugh scoring in the assessment of prognosis in cirrhotic patients.
Key words: liver cirrhosis, prognosis, OGTT, IGF-I, transferrin.