| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
Journal of Clinical Endocrinology & Metabolism, Vol 77, 1263-1268, Copyright © 1993 by Endocrine Society
ARTICLES |
MR Letiexhe, AJ Scheen, PL Gerard, BH Bastens, J Pirotte, J Belaiche and PJ Lefebvre
Department of Medicine, CHU Sart Tilman, University of Liege, Belgium.
To study the mechanisms of glucose intolerance and hyperinsulinism in liver cirrhosis, we compared the plasma glucose, insulin, and C-peptide levels during a frequently sampled i.v. glucose tolerance test (0.3 g glucose/kg BW) in nine compensated cirrhotic patients and nine healthy volunteers well matched for age, sex, and body weight. The insulin secretion rate was derived by the deconvolution of plasma C-peptide levels, insulin sensitivity was calculated using Bergman's minimal model method, and insulin clearance was estimated by dividing the 0-180 min area under the curve of insulin secretion rate by that of peripheral plasma insulin levels. The cirrhotic patients were characterized during the frequently sampled i.v. glucose tolerance test by a 60% greater insulin secretion rate (P < 0.05), a markedly reduced insulin sensitivity index (SI; 2.82 +/- 0.75 vs. 5.86 +/- 0.68 x 10(-4) min/mU.L; P < 0.01) and a 40% reduced insulin clearance (725 +/- 169 vs. 1165 +/- 99 mL/min.m-2; P < 0.05). The reduction of insulin clearance was significantly correlated with the amplitude of the portosystemic shunt, measured using an isotopic method (r = 0.75; P < 0.02). In conclusion, cirrhosis is characterized by an important peripheral hyperinsulinism, resulting from both a higher insulin secretion rate and a reduced insulin hepatic clearance; the severe insulin resistance explains the glucose metabolism alterations.
This article has been cited by other articles:
 |
|
 |
|
  A. Kotronen, S. Vehkavaara, A. Seppala-Lindroos, R. Bergholm, and H. Yki-Jarvinen Effect of liver fat on insulin clearance Am J Physiol Endocrinol Metab, December 1, 2007; 293(6): E1709 - E1715. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A V Greco, G Mingrone, A Mari, E Capristo, M Manco, and G Gasbarrini Mechanisms of hyperinsulinaemia in Child's disease grade B liver cirrhosis investigated in free living conditions Gut, December 1, 2002; 51(6): 870 - 875. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 L. Tappy, P. Schneiter, R. Chiolero, V. Bettschart, and M. Gillet Effects of a Glucose Meal on Energy Metabolism in Patients With Cirrhosis Before and After Liver Transplantation Arch Surg, January 1, 2001; 136(1): 80 - 84. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 W. C. Duckworth, R. G. Bennett, and F. G. Hamel Insulin Degradation: Progress and Potential Endocr. Rev., October 1, 1998; 19(5): 608 - 624. [Abstract] [Full Text]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
| Endocrinology | Endocrine Reviews | J. Clin. End. & Metab. |
| Molecular Endocrinology | Recent Prog. Horm. Res. | All Endocrine Journals |
