Abstract
The in vivo dose response curve to insulin were studied, using an euglycemic insulin clamp technique, in 13 cirrhotic patients [8 with 'hepatocellular' (HC) (nonalcoholics) and 5 with 'cholestatic' (CHOL) cirrhosis] and 12 healthy controls (N). Subjects were studied in the basal state and during infusion of insulin at 3 different rates - 1, 3, 10 mU kg-1 min-1. Insulin responsiveness was similar in N and in HC, but it was 23% greater in CHOL (p < 0.001). Insulin sensitivity was decreased in cirrhotics as compared with N but this difference was only significant (p < 0.001) in HC. (ED50:62 + 5, 88 + 13 and 136 + 16 μU ml-1 in N, CHOL and HC respectively). Insulin clearance rate (ICR) was significantly (p < 0.005) decreased in HC (1060 ± 80, 996 ± 95 and 776 ± 128 ml sq m-1 ml-1 in N, CHOL and HC respectively. Basal hepatic glucose production (BHGP) was 39% lower in HC (p < 0.005) and 24% lower in CHOL (p < 0.05) than in N. Erythrocyte cholesterol phospholipid ratio was significantly elevated (p < 0.001) in both groups of cirrhotic patients but was not correlated to specific metabolic changes described. In summary: i) intervariations in insulin dependent glucose metabolism, were described in different cirrhotic groups; ii) basal hepatic glucose production and insulin clearance rate impaired in the different groups of cirrhotics; iii) the role of decreased cholesterol/phospholipid ratio on tissues glucose metabolism in cirrhotic patients should be further studied.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 727-735 |
| Number of pages | 9 |
| Journal | Journal of Endocrinological Investigation |
| Volume | 14 |
| Issue number | 9 |
| State | Published - 1991 |
| Externally published | Yes |
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Keywords
- Cholestatic cirrhosis
- Glucose
- Hepatocellular cirrhosis
- Insulin
- Insulin resistance
ASJC Scopus subject areas
- Endocrinology
Cite this
In vivo insulin action in hepatocellular and cholestatic liver cirrhosis. / Barzilai, Nir; Cohen, P.; Karnieli, E.; Enat, R.; Epstein, O.; Owen, J.; McIntyre, N.
In: Journal of Endocrinological Investigation, Vol. 14, No. 9, 1991, p. 727-735.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - In vivo insulin action in hepatocellular and cholestatic liver cirrhosis
AU - Barzilai, Nir
AU - Cohen, P.
AU - Karnieli, E.
AU - Enat, R.
AU - Epstein, O.
AU - Owen, J.
AU - McIntyre, N.
PY - 1991
Y1 - 1991
N2 - The in vivo dose response curve to insulin were studied, using an euglycemic insulin clamp technique, in 13 cirrhotic patients [8 with 'hepatocellular' (HC) (nonalcoholics) and 5 with 'cholestatic' (CHOL) cirrhosis] and 12 healthy controls (N). Subjects were studied in the basal state and during infusion of insulin at 3 different rates - 1, 3, 10 mU kg-1 min-1. Insulin responsiveness was similar in N and in HC, but it was 23% greater in CHOL (p < 0.001). Insulin sensitivity was decreased in cirrhotics as compared with N but this difference was only significant (p < 0.001) in HC. (ED50:62 + 5, 88 + 13 and 136 + 16 μU ml-1 in N, CHOL and HC respectively). Insulin clearance rate (ICR) was significantly (p < 0.005) decreased in HC (1060 ± 80, 996 ± 95 and 776 ± 128 ml sq m-1 ml-1 in N, CHOL and HC respectively. Basal hepatic glucose production (BHGP) was 39% lower in HC (p < 0.005) and 24% lower in CHOL (p < 0.05) than in N. Erythrocyte cholesterol phospholipid ratio was significantly elevated (p < 0.001) in both groups of cirrhotic patients but was not correlated to specific metabolic changes described. In summary: i) intervariations in insulin dependent glucose metabolism, were described in different cirrhotic groups; ii) basal hepatic glucose production and insulin clearance rate impaired in the different groups of cirrhotics; iii) the role of decreased cholesterol/phospholipid ratio on tissues glucose metabolism in cirrhotic patients should be further studied.
AB - The in vivo dose response curve to insulin were studied, using an euglycemic insulin clamp technique, in 13 cirrhotic patients [8 with 'hepatocellular' (HC) (nonalcoholics) and 5 with 'cholestatic' (CHOL) cirrhosis] and 12 healthy controls (N). Subjects were studied in the basal state and during infusion of insulin at 3 different rates - 1, 3, 10 mU kg-1 min-1. Insulin responsiveness was similar in N and in HC, but it was 23% greater in CHOL (p < 0.001). Insulin sensitivity was decreased in cirrhotics as compared with N but this difference was only significant (p < 0.001) in HC. (ED50:62 + 5, 88 + 13 and 136 + 16 μU ml-1 in N, CHOL and HC respectively). Insulin clearance rate (ICR) was significantly (p < 0.005) decreased in HC (1060 ± 80, 996 ± 95 and 776 ± 128 ml sq m-1 ml-1 in N, CHOL and HC respectively. Basal hepatic glucose production (BHGP) was 39% lower in HC (p < 0.005) and 24% lower in CHOL (p < 0.05) than in N. Erythrocyte cholesterol phospholipid ratio was significantly elevated (p < 0.001) in both groups of cirrhotic patients but was not correlated to specific metabolic changes described. In summary: i) intervariations in insulin dependent glucose metabolism, were described in different cirrhotic groups; ii) basal hepatic glucose production and insulin clearance rate impaired in the different groups of cirrhotics; iii) the role of decreased cholesterol/phospholipid ratio on tissues glucose metabolism in cirrhotic patients should be further studied.
KW - Cholestatic cirrhosis
KW - Glucose
KW - Hepatocellular cirrhosis
KW - Insulin
KW - Insulin resistance
UR - http://www.scopus.com/inward/record.url?scp=0025992045&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0025992045&partnerID=8YFLogxK
M3 - Article
C2 - 1761807
AN - SCOPUS:0025992045
VL - 14
SP - 727
EP - 735
JO - Journal of Endocrinological Investigation
JF - Journal of Endocrinological Investigation
SN - 0391-4097
IS - 9
ER -