INSULIN RESISTANCE IN CIRRHOSIS: EVIDENCE FOR A POST‐RECEPTOR DEFECT

Abstract

Receptor and post‐receptor abnormalities of insulin action and their possible role in the insulin resistance of cirrhosis were examined in eight biopsy‐proven cirrhotic subjects and eight age‐weight matched healthy volunteers. To this end, oral glucose tolerance tests (OGTT), insulin dose response curves and insulin binding to circulating monocytes were determined for each subject. The dose‐response curves for the cirrhotic subjects were significantly shifted to the right compared to the control subjects, indicating the presence of insulin insensitivity (ED50 223 ± 30 versus 64 ± 8 mU/l respectively; P<0.001). The magnitude of the right shift of the insulin‐dose response curves correlated si..