Reference : Insulin secretion, clearance, and action on glucose metabolism in cirrhotic patients.
Scientific journals : Article
Human health sciences : Endocrinology, metabolism & nutrition
http://hdl.handle.net/2268/14017
Insulin secretion, clearance, and action on glucose metabolism in cirrhotic patients.
English
Letiexhe, Michel mailto [Centre Hospitalier Universitaire de Liège - CHU > > Diabétologie,nutrition, maladies métaboliques >]
Scheen, André mailto [Université de Liège - ULiège > Département des sciences cliniques > Diabétologie, nutrition et maladie métaboliques - Médecine interne générale >]
Gerard, Pascale [Centre Hospitalier Universitaire de Liège - CHU > > Neurologie CHR >]
Bastens, B. H. [> > > >]
Pirotte, Jeannine [Université de Liège - ULiège > Département des sciences cliniques > Médecine générale >]
Belaiche, Jacques mailto [Centre Hospitalier Universitaire de Liège - CHU > > Gastro-Entérologie-Hépatologie >]
Lefebvre, Pierre [Centre Hospitalier Universitaire de Liège - CHU > > Diabétologie,nutrition, maladies métaboliques >]
1993
Journal of Clinical Endocrinology and Metabolism
Endocrine Society
77
5
1263-8
Yes (verified by ORBi)
0021-972X
1945-7197
Chevy Chase
MD
[en] Adolescent ; Adult ; Aged ; Female ; Glucose/metabolism ; Glucose Tolerance Test ; Hormones/blood ; Humans ; Insulin/pharmacokinetics/pharmacology/secretion ; Liver/metabolism ; Liver Cirrhosis/metabolism ; Male ; Middle Aged
[en] 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.
http://hdl.handle.net/2268/14017
10.1210/jc.77.5.1263

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