Mo1976 Plasma Levels Cytokine Imbalance in Compensated Cirrhotic Patients With Impaired Glucose Tolerance and Diabetes Mellitus. A Prospective Study

Abstract

Background and Aims: To define if there is an imbalance in plasma levels of some proinflammatory, fibrogenic and antifibrogenic cytokines of patients with liver cirrhosis (LC) and impaired glucose tolerance (IGT) or Diabetes Mellitus (DM) . Methods: We studied 54 patients with compensated LC who had normal fasting plasma glucose (FPG) levels. An oral glucose tolerance test (OGTT) was carried out:18 patients were normal, 18 had IGT, and 18 had DM. Plasma levels of the following cytokines were measured: TNF-α, Soluble Tumor Necrosis Factor Receptor 1 (sTNF-R1), Leptin, TGF-β1, and Hepatocyte Growth Factor (HGF). Also, fasting plasma insulin (FPI) levels were measured and HOMA2-IR was calculated. Results were compared with those of a control group of 18 patients without liver disease or DM. Data were expressed as medians and interquartile ranges. Intergroup comparison was performed using non parametric tests. Results:. Patients with IGT and DM had significantly higher sTNF-R1 (p = 0.0043 and 0.0045 respectively) (Figure 1) and significantly lower TGF-β1 (p = 0.001 and 0.001 respectively) (Figure 2) compared to controls. Leptin , HGF, and TNF-α showed no significant differences among cirrhotic patient and controls. Correlations between sTNF-R1 and HOMA2-IR and between leptin and HOMA2-IR were found. Conclusions: IGT and DM were associated to an imbalance of sTNF-R1 and TGFβ1 in cirrhotic patients. At the same time sTNF-R1and leptin correlated with IR. These findings may suggest that sTNF-R1 might be implicated in the development of DM or in the deterioration of liver function in cirrhotic patients with DM.