IMPAIRED GLUCOSE TOLERANCE AND PANCREATIC DUCT ABNORMALITY IN ALCOHOL CONSUMED LIVER CIRRHOSIS

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Ninety seven percent of 30 alcohol consumed cirrhotics showed abnormal oral glucose tolerance (OGTT). Of these, 14 out of 22 patients, when examined by endoscopicretrograde pancreatography (ERP), showed abnormal pancreatograms. Mean IRI, but no c-peptide, response to OGTT, were higher in these patients when compared with diabetic groups. However, the more severe the pancreatic abnormality, the lower were both serum insulin and c-peptide responses.Insulinogenic index (1.1.) also inversely correlated with the grade of ERP abnormality. It was higher in the patient who had normal pancreatogram than the patient with diabetes mellitus. 1.1. had no correlation to the grade of liver injury estimated with ICG test or A/G ratio. The molar ratio CPR/IRI in patients who had more than grade II liver damage estimated with Au liver scan, was lower than controls.It seemed likely that pancreatic damage induced by chronic alcohol addiction was one of the important factors for the impaired glucose tolerance in alcohol consumed patients with liver cirrhosis, and one of the reasons for IRI hyperreactivity in these patients was impaired insulin metabolism in the liver.
財団法人日本消化器病学会の論文