Oral glucose tolerance in patients with jaundice

Abstract

A glucose tolerance test was performed on 21 patients with jaundice. The glucose tolerance patterns were principally classified into a parabolic pattern characterized by the return toward normal within 120 minutes and a linear pattern with long-standing increase for more than 120 minutes. Of these, 13 patients showed the parabolic pattern and tolerated the operation well. The other eight patients showed the linear pattern. Of the latter, four patients died within three weeks postoperatively, and the others died without leaving the hospital following operation. From the results, it was suggested that the parabolic glucose tolerance pattern is indicative of compensated damage to the liver, while the linear glucose tolerance pattern shows critically decreased hepatic functional reserve. Experimentally, the close relationship between the severity of the derangement of metabolism in the mitochondria of the liver and the degree of glucose intolerance was studied in rats and rabbits with jaundice subjected to the ligation of the common bile duct. In rats with jaundice in which the phosphorylative activity is significantly higher than that in the mitochondria from the tissues of the liver deprived of endogenous insulin through portal blood, the parabolic patterns develop. In rabbits with jaundice in which the phosphorylative activity is considerably lower than that in the mitochondria from tissues of the liver deprived of endogenous insulin, the linear pattern occurs. It was suggested that the two distinct patterns in patients with jaundice are closely related to the severity of the derangement of the phosphorylative activity of the mitochondria.