Blood glucose and glucoregulatory hormones in liver cirrhosis: a study of 24 hour profiles and of the role of portal-systemic shunting
Marchesini, G.; Zoli, M.; Dondi, C.; Angiolini, A.; Forlani, G.; Melli, A.; Bianchi, F.B.; Pisi, E.
Gastroenterologie Clinique et Biologique 6(3): 272-278
1982
ISSN/ISBN: 0399-8320 PMID: 7047286 Document Number: 189613
The levels of blood glucose, insulin and glucagon were measured during a 24-h period in 7 healthy subjects and in 2 groups of 7 cirrhotics, on a strict controlled dietary regimen. The 2 groups of cirrhotic patients had similar liver tests, but differed from each other by the presence or absence of spontaneous portosystemic shunting, evaluated endoscopically by the existence of esophageal varices and by the ammonia tolerance test. Postprandial glycemia and the area under the 24-h glucose curve were significantly increased in both groups of patients, in spite of normal basal blood glucose levels. Hyperinsulinemia and hyperglucagonemia, both in the basal state and throughout the day, were only demonstrated in patients with spontaneous portosystemic shunting. The insulin/blood glucose molar ratio, assumed as an index of tissue sensitivity to insulin, was normal in cirrhotics without portosystemic shunts, but was significantly raised in patients with portosystemic shunts. The insulin/glucagon molar ratio was reduced in both groups of cirrhotics in the basal state, while the mean area under the curve was normal. Significant alterations in carbohydrate metabolism are apparently present in cirrhotics throughout the day. These changes seem to be mainly due to the shunting of blood around the liver. Liver dysfunction may play a role in postprandial glycemia.