CIRRHOSIS OF LIVER AND INSULIN RESISTANCE- AN OBSERVATIONAL STUDY IN ASSAM

Abstract

Background:- The prevalence rate of Diabetes Mellitus in cirrhosis of liver varies from 35 to 71%. Diabetes developing in such cases is referred to as Hepatogenous Diabetes. Studies on insulin resistance and Cirrhosis of Liver in North-East India is, however, limited. Aims And Objectives- 1) To estimate fasting plasma glucose and fasting Insulin levels in patients with Cirrhosis of Liver. 2) To calculate HOMA-IR in these patients. Materials And Methods- Ahospital-based observational study on 110 non-Diabetic patients having Liver Cirrhosis was undertaken. Cases were divided according to Child Pugh classication into Grade A, B and C. Fasting plasma glucose and fasting Insulin were estimated in VITROS-5600 Autoanalyzer and HOMA-IR was determined for each case. Results-The mean insulin level was 5.8±2.3 in Child Pugh A, 7.5±3.5 in Child Pugh B and 22.2±11.5 in Child Pugh C. The mean HOMA-IR was 1.3±0.6 in Child Pugh A, 1.8±0.9 in Child Pugh B and 5.8±3.5 in Child Pugh C. The difference in Fasting Insulin and HOMA-IR in Child Pugh Grade A, B and C was found to be statistically signicant (p<0.05). Conclusion- It can be concluded that insulin resistance is maximum in cases with Cirrhosis of Liver having highest Child Pugh grading. Follow-up studies may help in demonstrating Insulin Resistance with increasing grade of Liver Cirrhosis.