[Oral glucose tolerance test and glucagon loading test as useful parameters for evaluating liver functional reserve]

Oral glucose tolerance test (OGTT) and glucagon loading test (GLT) were performed preoperatively in 46 patients with hepatocellular carcinoma and underlying liver cirrhosis. After operation 17 cases fared with good recovery (group A), 17 with hepatic functional damages (group B) and 12 with liver failure (group C). The glucose tolerance patterns could be classified into three types: (1) blood glucose level returned to 7.3 mmol/L or less 120 minutes after glucose loading, in 82.4% of the patients in group A, (2) with return of glucose level but greater than 7.3 mmol/L, in 60% of the cases in group B and 20% in group C, (3) linear pattern with increasing of glucose level in 100% of the patients in group B or C. For GLT, the plasma cyclic AMP concentration reached a peak level at 10 minute and the peak level/basal level (P/B ratio) was found to be a reliable index, that 70.6% of the patients in group A had a P/B ratio greater than 20, 64.7% in group B with the ratio between 10-20, and 83.3% in group C with that less than 10. For evaluating liver functional reserve, predictability test indicated the sensitivity and efficiency were greater significantly for OGTT and GLT than Pugh's grading (P < 0.05).