Investigation of insulin resistance in patients with liver cirrhosis and its relationship with severity of disease

¯Abstract Background: Insulin resistance and glucose intolerance are commonly associated with liver cirrhosis. Resistance to insulin is an important prognostic factor in liver cirrhosis. Objective: To determine the relationship between insulin resistance and severity of liver cirrhosis. Methods: This was a descriptive-analytic study carried out on 76 patients with stablished liver cirrhosis in Booali hospital (Qazvin) in 2006 and 2007. Their fasting blood sugar, serum insulin level and oral glucose tolerance test (OGTT) were measured. Patients divided into three groups of A, B and C according to the child-pugh classification. Insulin resistance was determined by the homeostasis model assessment (HOMA-IR) in all patients. Data analysis was performed using t test, variance analysis, chi-square and Fishers exact test. Findings: Cirrhosis was found to be strongly associated with insulin resistance (60.5%) and the values obtained for prevalence of insulin resistance for groups A, B, and C of Child-Pugh Classification were %31.6, %66.7 and %74.1, respectively. The relationship between IR and severity of liver cirrhosis was significant, statistically (p=0.01). Diabetes mellitus was diagnosed in 26 subjects (34.2%), impaired glucose tolerance in 24 (31.6%) and normal glucose tolerance in 26 (34.2%) using OGTT. Conclusion: Insulin resistance increased with stage of liver cirrhosis as defined by Child-Pugh score.