Decreased insulin binding to red blood cells in liver cirrhosis

eleven male cirrhotic subjects, all with impaired glucose tolerance (IGT), were studied. Insulin binding to circulating erythrocytes was evaluated. The specific bound fraction was decreased compared to normals (5.95 +/-0.76 vs 7.08 +/- 0.84%; p less than 0.005). An negative correlation was found between fasting insulin and bound fraction (r = -0.68; p less than 0.05). We suggest that serum insulin may be chronically augmented as a consequence of liver damage. This induces a down-regulation of insulin receptors that is responsible for insulin resistance and at least in part for the impairment of glucose tolerance.