A Study of Carbohydrate Metabolism in Postnecrotic Cirrhosis Liver

Overview

Journal Gut

Specialty Gastroenterology

Date 1974 Nov 1

PMID 4455570

Citations 9

Authors

R T YEUNG

C C Wang

Affiliations

Soon will be listed here.

Abstract

Intravenous glucose tolerance, insulin tolerance, tolbutamide, and glucagon tests were carried out in 21 patients with postnecrotic cirrhosis. Based arbitrarily on the bromsulphthalein retention they were divided into group A, nine patients with less impaired liver function, and group B, 12 patients with greater impairment of liver function. Intravenous glucose and insulin tolerances were reduced in both groups. The hypoglycaemic effect of tolbutamide was similar in the controls and in both groups of cirrhotic patients but this was achieved at higher plasma insulin levels in group B indicating resistance of the liver to the effect of endogenous insulin. The blood glucose response to glucagon was markedly impaired in group B patients which is consistent with this hypothesis. In contrast to the insulin response to glucose and tolbutamide, the insulin response to glucagon was reduced in the cirrhotic patients. Fasting human growth hormone and free fatty acid levels were elevated in both groups but they were not considered to be important factors in the production of insulin resistance.

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References

Olefsky J, Farquhar J, Reaven G . Relationship between fasting plasma insulin level and resistance to insulin-mediated glucose uptake in normal and diabetic subjects. Diabetes. 1973; 22(7):507-13. DOI: 10.2337/diab.22.7.507. View

KASPERSKA T, LAWECKI J, ROGALA H, Czyzyk A . The behaviour of insulinaemia in patients ith liver cirrhosis after intravenous administration of glucose, tolbutamide and glucagon. Diabetologia. 1971; 7(5):391-4. DOI: 10.1007/BF01219476. View

Hernandez A, ZORRILLA E, GERSHBERG H . Decreased insulin production, elevated growth hormone levels, and glucose intolerance in liver disease. J Lab Clin Med. 1969; 73(1):25-33. View

Creutzfeldt W, Wille K, KAUP H . [Intravenous injections of glucose, insulin and tolbutamide in healthy persons, diabetics, cirrhotics, and patients with insuloma (together with a contribution on the diagnostic value of the tolbutamide tests)]. Dtsch Med Wochenschr. 1962; 87:2189-95. DOI: 10.1055/s-0028-1114074. View

MORTIAUX A, Dawson A . Plasma free fatty acid in liver disease. Gut. 1961; 2:304-9. PMC: 1413354. DOI: 10.1136/gut.2.4.304. View

Megyesi C, Samols E, Marks V . Glucose tolerance and diabetes in chronic liver disease. Lancet. 1967; 2(7525):1051-6. DOI: 10.1016/s0140-6736(67)90334-0. View

Hales C, Randle P . Immunoassay of insulin with insulin-antibody precipitate. Biochem J. 1963; 88:137-46. PMC: 1203862. DOI: 10.1042/bj0880137. View

LOZNER E, Winkler A, Taylor F, Peters J . THE INTRAVENOUS GLUCOSE TOLERANCE TEST. J Clin Invest. 1941; 20(5):507-15. PMC: 435080. DOI: 10.1172/JCI101243. View

Berkowitz D . Glucose tolerance, free fatty acid, and serum insulin responses in patients with cirrhosis. Am J Dig Dis. 1969; 14(10):691-9. DOI: 10.1007/BF02233575. View

10.

Randle P, Garland P, Hales C, Newsholme E . The glucose fatty-acid cycle. Its role in insulin sensitivity and the metabolic disturbances of diabetes mellitus. Lancet. 1963; 1(7285):785-9. DOI: 10.1016/s0140-6736(63)91500-9. View

11.

SCHALCH D, Parker M . A SENSITIVE DOUBLE ANTIBODY IMMUNOASSAY FOR HUMAN GROWTH HORMONE IN PLASMA. Nature. 1964; 203:1141-2. DOI: 10.1038/2031141a0. View

12.

Danowski T, GILLESPIE H, FERGUS E, PUNTERERI A . Significance of blood sugar and serum electrolyte changes in cirrhosis following glucose, insulin, glucagon, or epinephrine. Yale J Biol Med. 1956; 29(3):361-75. PMC: 2603865. View

13.

Samols E, Ryder J . Studies on tissue uptake of insulin in man using a differential immunoassay for endogenous and exogenous insulin. J Clin Invest. 1961; 40:2092-102. PMC: 290913. DOI: 10.1172/JCI104435. View

14.

TROUT D, ESTES Jr E, FRIEDBERG S . Titration of free fatty acids of plasma: a study of current methods and a new modification. J Lipid Res. 1960; 1:199-202. View

15.

McIntyre N, HOLDSWORTH C, Turner D . Intestinal factors in the control of insulin secretion. J Clin Endocrinol Metab. 1965; 25(10):1317-24. DOI: 10.1210/jcem-25-10-1317. View

16.

SAMAAN N, Stone D, ECKHARDT R . Serum glucose, insulin, and growth hormone in chronic hepatic cirrhosis. Arch Intern Med. 1969; 124(2):149-52. View