A CLINICAL STUDY OF ORAL GLUCOSE TOLERANCE TEST IN CHRONIC LIVER DISEASE

Background: as liver is the principal organ for metabolism of the carbohydrates, chronic liver disease (CLD) may affect carbohydrate metabolism. Hence we can utilise oral glucose tolerance test (OGTT) to study the disturbances in carbohydrate metabolism in CLD. Objectives include: 1) To know clinical features and laboratory manifestations of chronic liver disease. 2) To know various results of OGTT in CLD. 3) To study various classes of cirrhosis (as in child-grading) Methods: Study was conducted over a period of 18 months in Katuri medical college where clinical, laboratory manifestations and OGTT results in 30 cases of CLD and 30 controls (age and sex matched) with cured respiratory tract infection. Age more than 65 years, pregnant women, patients with h/o diabetes, clinical features suggestive of chronic cholestatic diseases and h/o alcoholism in controls were excluded from the present study. Results: CLD was found to be more common in males (73.3%) than females. CLD was more common in lower socioeconomic status (63%). Male: female ratio is equal for chronic hepatitis C equals to one. Alcoholic cirrhosis, chronic alcohol hepatitis and primary hepatoma with cirrhosis were seen only in male and cryptogenic cirrhosis was seen in only female. Most of the cases had anemia. Cirrhosis is the most common cause for CLD (66.6%/20 cases). OGTT showed rise in blood sugar levels in cases which was significant when compared with control group (p<0.05). OGTT showed impaired response in 46.6% cases, impaired glucose tolerance (IGT) in 23.3%, diabetic response in 23.3% and normal response in 53.3% cases. Cirrhosis is the most common (78.5%) cause for impaired glucose response. Conclusions: It can be concluded that CLD is more common in male and lower socioeconomic status. There is significant impaired response to glucose load in CLD. Cirrhosis, among CLD?s is the most common etiology for impaired response.