Subclinical abnormal glucose tolerance is a predictor of death in liver cirrhosis

Table 1 Clinical and biochemical characteristics of cirrhotic patients

Variable	Total (n = 100)	NGT (n = 30)	SAGT (n = 70)
Age, yr	53.9 ± 11.8	49.0 ± 12.0	56.0 ± 11.11
BMI, kg/m2	26.9 ± 4.2	26.4 ± 4.40	27.21 ± 4.15
Males	60 (60)	18 (60)	42 (60)
Etiology: Alcohol	47 (47)	14 (46.6)	33 (47.1)
HBV	4 (4)	1 (3.3)	3 (4.2)
HCV	13 (13)	2 (6.6)	11 (15.7)
Autoimmunity	10 (10)	3 (10)	7 (10)
Cryptogenic	26 (26)	10 (33.3)	16 (22.8)
Liver biopsy	44 (44)	13 (43.3)	31 (44.2)
Length of LC, mo	21.6 + 27.6	21.4 ± 30.6	21.7 ± 33.2
Hemoglobin, g/dL	11.8 ± 2.3	11.6 ± 2.1	11.9 ± 2.3
Platelets, × mm3	128140 ± 89501	159186 ± 112108	114834 ± 73269
INR	1.3 ± 0.3	1.2 ± 0.3	1.36 ± 0.32
Creatinine, mg/dL	0.8 ± 0.2	0.90 ± 0.33	0.83 ± 0.2
Albumin, g/dL	3.2 ± 0.73	3.33 ± 0.71	3.21 ± 0.74
ALT, UI/L	46.5 ± 40.8	48.9 ± 53.9	45.4 ± 34.0
Total bilirubin, mg/dL	1.71 ± 0.90	1.55 ± 0.88	1.78 ± 0.91
Fasting plasma insulin, μU/mL	15.9 ± 10.2	11.9 ± 7.6	18.2 ± 113
HOMA2 score	2.67 ± 1.6	2.36 ± 1.46	4.6 ± 3.34
Child-Pugh A	47 (47)	15 (50)	32 (45.7)
B	53 (53)	15 (50)	38 (54.2)
Child Pugh score	6.8 ± 1.8	6.5 ± 1.61	6.82 ± 1.67
MELD score	8.94 ± 4.8	8.3 ± 5.2	9.21 ± 4.63
Survival, d	1237	1448	1116
	(990-1925)	(1256-1925)	(990-1790)5

Data are expressed as absolute numbers (percentage) or mean ± SD.

¹P = 0.003;

²P = 0.025;

³P = 0.03;

⁴P = 0.009;

⁵P = 0.045. NGT: Normal glucose tolerance; SAGT: Subclinical abnormal glucose tolerance; HOMA: Homeostatic model assessment; LC: Liver cirrhosis. BMI: Body mass index; MELD: Model for End-Stage Liver Disease; HBV: Hepatitis B virus; HCV: Hepatitis C virus; INR: International normalized ratio; ALT: Alanine transaminase.

Table 2 Annual cumulated survival of cirrhotic patients n (%)

Year(s)	NGT (n = 30)	SAGT (n = 70)	P value (χ2test)
1	2 (93)	9 (87)	0.36
2	4 (83.2)	14 (79)	0.34
3	4 (83.2)	23 (51.4)	0.04
4	4 (83.2)	24 (47.5)	0.03
5	5 (71.6)	26 (31.7)	0.02

NGT: Normal glucose tolerance; SAGT: Subclinical abnormal glucose tolerance.

Table 3 Causes of death n (%)

Cause	Total (n = 31)
Variceal bleeding	8 (25.8)
Liver failure	6 (19.3)
SBP e infection	5 (16.2)
Hepatorenal syndrome	5 (16.2)
HCC	4 (12.9)
Renal impairment	2 (6.4)
Cardiovascular	1 (3.2)

SBP: Spontaneous bacterial peritonitis; HCC: Hepatocellular carcinoma.

Table 4 Univariate and multivariate analyses: Independent predictors of death

Variable	HR	95%CI	P value	HR	95%CI	P value
Creatinine	1.6	1.2-40.2	0.030	2.62	0.5-3.46	0.650
Albumin	3.4	1.8-22.3	0.015	6.3	0.4-32.1	0.180
INR	2.2	1.6-32.4	0.050	3.5	0.3-23.6	0.230
Child-Pugh B	7.2	3.4-33.0	0.0003	8.2	2.0-28.5	0.020
Child Pugh score	5.2	2.9-25.8	0.008	10.2	2.4-21.9	0.008
MELD score	8.1	4.2-18.7	0.001	12.3	6.4-33.6	0.001
SAGT	4.5	2.0-15.2	0.042	3.2	2.8-54.2	0.010
Fasting serum insulin	1.2	1.0-33.5	0.040	3.2	0.1-27.3	0.320

MELD: Model for end stage liver disease; INR: International normalized ratio; SAGT: Subclinical abnormal glucose tolerance.