Attempts to utilize disturbances of carbohydrate metabolism for a diagnosis of functional impairment of the liver are not new. But the levulose and galactose tolerance tests that are available do not give sufficiently uniform results to warrant their general adoption. The objections to these sugar tolerance tests as an indication of liver function are twofold. The first and real objection is that while sugar metabolism suffers in certain diseases of the liver, this fact is susceptible of consistent demonstration only by group averages. In individual cases of even proved diseases of the liver, the results of these tests frequently fall within the limits of normal and minimize their significance. The second objection is that other organs, such as the pancreas and the hypophysis, also play a prominent part in the metabolism of carbohydrates, and therefore any discovered abnormalities of such metabolism may not be due specifically to a deficiency of
ALTHAUSEN TL, GUNTHER L, LAGEN JB, KERR WJ. MODIFICATION OF THE DEXTROSE TOLERANCE TEST AS AN INDEX OF METABOLIC ACTIVITY OF THE LIVER. Arch Intern Med (Chic). 1930;46(3):482–493. doi:10.1001/archinte.1930.00140150123010
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