Hemoglobin A1 in cirrhosis of the liver.

Patients with cirrhosis of the liver (LC group, n = 12) frequently have glucose intolerance secondary to hepatic dysfunction. We compared HbA1 levels and other measures of blood sugar control in the LC group with those in healthy controls (N group, n = 43), patients with diabetes mellitus (DM group, n = 36), or patients with chronic hepatitis without evidence of cirrhosis (CH group, n = 12). HbA1 levels and the mean values of fasting plasma glucose for the past month (FPG) were as follows: LC group 6.40 +/- 0.36 (mean +/- SEM)% and 130 +/- 20 mg/dl, DM group 10.29 +/- 0.45% and 172 +/- 11 mg/dl, CH group 10.70 +/- 0.86% and 176 +/- 21 mg/dl, N group 6.52 +/- 0.11% and 83 +/- 1 mg/dl, respectively. HbA1 in the LC group was similar to that in the N group, although FPG in the former was higher (p less than 0.05). All groups showed statistically significant positive correlations between HbA1 levels and (a) FPG, (b) the daily profile of plasma glucose values, (c) the total or peak plasma glucose values during a 50 g-OGTT. The regression line in the LC group, however, was statistically different from that in DM or CH group. Thus, HbA1 in the LC group is lower than that in DM or CH in spite of equivalent glucose intolerance. Therefore, we suggest caution in the interpretation of HbA1 levels in hepatic cirrhosis.