GLUCAGON AND INSULIN METABOLISM IN CIRRHOTIC-PATIENTS

Citation
T. Yoshida et al., GLUCAGON AND INSULIN METABOLISM IN CIRRHOTIC-PATIENTS, Hepato-gastroenterology, 45(20), 1998, pp. 468-471
Citations number
19
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Gastroenterology & Hepatology
Journal title
ISSN journal
0172-6390
Volume
45
Issue
20
Year of publication
1998
Pages
468 - 471
Database
ISI
SICI code
0172-6390(1998)45:20<468:GAIMIC>2.0.ZU;2-R
Abstract
BACKGROUND/AIMS: The aim of this study was to investigate glucagon and insulin metabolism in order to clarify the mechanisms that lead to hy perglucagonemia and hyperinsulinemia in cirrhosis. METHODOLOGY: Splanc hnic output and metabolic clearance rates were studied in 16 cirrhotic patients and 5 noncirrhotic controls. Splanchnic glucagon and insulin output into the portal circulation were calculated by the difference between portal venous and systemic arterial concentration multiplied b y portal plasma flow. The metabolic clearance rate was calculated as t he ratio of output to systemic arterial concentration. Portal blood fl ow was measured by continuous local thermodilution. RESULTS: Arterial glucagon levels were higher in cirrhotics than in controls. Glucagon o utput was triple of that found in controls (52.4+/-7.0 vs 17.7+/-2.9 n g/min, p<0.05). Both groups exhibited similar metabolic clearance rate s of glucagon. Systemic arterial insulin values were higher in cirrhot ics than in non-cirrhotics. Insulin output was not significantly diffe rent between the two groups. However, metabolic clearance of insulin i n cirrhotics was reduced to one half of the rate found in controls (23 7.0+/-39.8 vs. 450.5+/-17.5 mL/min, p<0.05). CONCLUSIONS: Hyperglucago nemia in cirrhotic patients results from increased pancreatic output, while hyperinsulinemia results from decreased insulin clearance.