Korelasi Skor Child Pugh dengan Kadar Glukosa Darah pada Penderita Sirosis Hati

Abstract

Background Alterations in carbohydrate metabolism are frequently observed in liver cirrhosis, both in fasting plasma glucose and 2 hours postload plasma glucose during Oral Glucose Tolerance Test (OGTT). In plenty of cases, diabetes seems to occur frequently in cirrhosis, and it is called hepatogenous diabetes. The Child Pugh classification is the most widely used model to determined severity in patients with liver cirrhosis. Methods Thirty-six patients with liver cirrhosis were enrolled in this cross-sectionally study. The Child Pugh score was calculated from each patient. In all cases, glucose tolerance was diagnosed by a 75 gram OGTT according to World Health Organization (WHO) criteria. And patients underwent venous plasma glucose with glucometer testing of capillary blood. The correlation of Child Pugh score with glucose blood level was investigated using Pearson analysis. Results Diabetes mellitus (DM) was diagnosed in 15 subjects (42%), glucose intolerance in 14 subjects (39%) and normal glucose tolerance in 7 subjects (19%). Pearsons analysis showed that Child Pugh score were correlated with fasting glucose (r=0,67 p=0,000) and 2 hours postload glucose (r=0,73 p=0,000). Conclusions Child Pugh score has a significance correlation with blood glucose level

Latar belakang Gangguan metabolisma glukosa sering dijumpai pada sirosis hati ditandai dengan terganggunya kadar glukosa darah puasa dan 2 jam beban glukosa saat dilakukan Tes Toleransi Glukosa Oral (TTGO). Pada banyak kasus, diabetes kelihatannya sering terjadi pada sirosis hati dan ini disebut hepatogenous diabetes. Klasifikasi Child Pugh merupakan model yang sering digunakan untuk menilai keparahan pasien sirosis hati. Metode Ada 36 pasien sirosis hati yang memenuhi syarat ikut dalam studi cross sectional ini. Skor Child Pugh dinilai untuk setiap pasien. Kemudian dilakukan penilaian toleransi glukosa dengan melakukan TTGO dengan meminum 75 gram glukosa sesuai dengan kriteria World Health Organization (WHO). Kadar glukosa darah semua pasien diperiksa melalui darah kapiler dengan alat glucometer. Korelasi skor Child Pugh dan kadar glukosa darah dinilai dengan analisa Pearson. Hasil Diabetes melitus (DM) dijumpai pada 15 subjek (42%), intoleransi glukosa pada 14 subjek (39%) dan toleransi glukosa normal pada 7 subjek (19%). Dengan analisa Pearson didapati bahwa skor Child Pugh berkorelasi dengan kadar glukosa darah puasa (r=0,67 p=0,000) dan 2 jam beban glukosa darah (r=0,73 p=0,000). Kesimpulan Skor Child Pugh berkorelasi positif bermakna dengan kadar glukosa darah