Skip to main content
NCBI home page
Gut logoLink to Gut
. 1974 Nov;15(11):907–912. doi: 10.1136/gut.15.11.907

A study of carbohydrate metabolism in postnecrotic cirrhosis of liver

Rose T T Yeung, Christina C L Wang
PMCID: PMC1413049  PMID: 4455570

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.

Full text

PDF
907

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Berkowitz D. Glucose tolerance, free fatty acid, and serum insulin responses in patients with cirrhosis. Am J Dig Dis. 1969 Oct;14(10):691–699. doi: 10.1007/BF02233575. [DOI] [PubMed] [Google Scholar]
  2. 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 Oct 26;87:2189–2195. doi: 10.1055/s-0028-1114074. [DOI] [PubMed] [Google Scholar]
  3. DANOWSKI T. S., GILLESPIE H. K., FERGUS E. B., PUNTERERI A. J. Significance of blood sugar and serum electrolyte changes in cirrhosis following glucose, insulin, glucagon, or epinephrine. Yale J Biol Med. 1956 Dec;29(3):361–375. [PMC free article] [PubMed] [Google Scholar]
  4. HALES C. N., RANDLE P. J. Immunoassay of insulin with insulin-antibody precipitate. Biochem J. 1963 Jul;88:137–146. doi: 10.1042/bj0880137. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Hernandez A., Zorrilla E., Gershberg H. Decreased insulin production, elevated growth hormone levels, and glucose intolerance in liver disease. J Lab Clin Med. 1969 Jan;73(1):25–33. [PubMed] [Google Scholar]
  6. 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 Oct;7(5):391–394. doi: 10.1007/BF01219476. [DOI] [PubMed] [Google Scholar]
  7. Lozner E. L., Winkler A. W., Taylor F. H., Peters J. P. THE INTRAVENOUS GLUCOSE TOLERANCE TEST. J Clin Invest. 1941 Sep;20(5):507–515. doi: 10.1172/JCI101243. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. MORTIAUX A., DAWSON A. M. Plasma free fatty acid in liver disease. Gut. 1961 Dec;2:304–309. doi: 10.1136/gut.2.4.304. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. McIntyre N., Holdsworth C. D., Turner D. S. Intestinal factors in the control of insulin secretion. J Clin Endocrinol Metab. 1965 Oct;25(10):1317–1324. doi: 10.1210/jcem-25-10-1317. [DOI] [PubMed] [Google Scholar]
  10. Megyesi C., Samols E., Marks V. Glucose tolerance and diabetes in chronic liver disease. Lancet. 1967 Nov 18;2(7525):1051–1056. doi: 10.1016/s0140-6736(67)90334-0. [DOI] [PubMed] [Google Scholar]
  11. Olefsky J., Farquhar J. W., Reaven G. Relationship between fasting plasma insulin level and resistance to insulin-mediated glucose uptake in normal and diabetic subjects. Diabetes. 1973 Jul;22(7):507–513. doi: 10.2337/diab.22.7.507. [DOI] [PubMed] [Google Scholar]
  12. RANDLE P. J., GARLAND P. B., HALES C. N., NEWSHOLME E. A. The glucose fatty-acid cycle. Its role in insulin sensitivity and the metabolic disturbances of diabetes mellitus. Lancet. 1963 Apr 13;1(7285):785–789. doi: 10.1016/s0140-6736(63)91500-9. [DOI] [PubMed] [Google Scholar]
  13. SAMOLS E., RYDER J. A. Studies on tissue uptake of insulin in man using a differential immunoassay for endogenous and exogenous insulin. J Clin Invest. 1961 Nov;40:2092–2102. doi: 10.1172/JCI104435. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. SCHALCH D. S., PARKER M. L. A SENSITIVE DOUBLE ANTIBODY IMMUNOASSAY FOR HUMAN GROWTH HORMONE IN PLASMA. Nature. 1964 Sep 12;203:1141–1142. doi: 10.1038/2031141a0. [DOI] [PubMed] [Google Scholar]
  15. Samaan N. A., Stone D. B., Eckhardt R. D. Serum glucose, insulin, and growth hormone in chronic hepatic cirrhosis. Arch Intern Med. 1969 Aug;124(2):149–152. [PubMed] [Google Scholar]
  16. TROUT D. L., ESTES E. H., Jr, FRIEDBERG S. J. Titration of free fatty acids of plasma: a study of current methods and a new modification. J Lipid Res. 1960 Apr;1:199–202. [PubMed] [Google Scholar]

Articles from Gut are provided here courtesy of BMJ Publishing Group

RESOURCES