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[Chronic liver diseases].

Y Aoki1, S Kawa, K Kiyosawa

  • 1Second Department of Internal Medicine, Shinshu University School of Medicine.

Nihon Rinsho. Japanese Journal of Clinical Medicine
|March 9, 2000
PubMed
Summary
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Insulin resistance is common in cirrhosis patients, leading to glucose intolerance and diabetes. Thiazolidinediones may help, but their use is restricted in patients with impaired liver function due to potential liver toxicity concerns.

Area of Science:

  • Hepatology
  • Endocrinology
  • Metabolic Diseases

Background:

  • Insulin resistance is prevalent in chronic liver diseases, particularly cirrhosis.
  • Glucose intolerance affects 60-80% of cirrhosis patients, with 10-30% developing diabetes mellitus.
  • Impaired insulin secretion in cirrhosis struggles to compensate for insulin resistance.

Purpose of the Study:

  • To evaluate the potential of insulin sensitizers, such as thiazolidinediones, for treating insulin resistance in cirrhotic patients.
  • To highlight the contraindication of thiazolidinediones in patients with compromised liver function until safety is established.

Main Methods:

  • Review of existing literature on insulin resistance in cirrhosis.
  • Analysis of the pathophysiology linking liver disease, insulin resistance, and glucose metabolism.

Related Experiment Videos

  • Assessment of thiazolidinedione class effects and known side effects.

    • Main Results:

    • Insulin resistance significantly contributes to glucose intolerance and diabetes in cirrhosis.
    • Thiazolidinediones are insulin sensitizers that could theoretically benefit these patients.
    • Potential hepatotoxicity of thiazolidinediones necessitates caution in cirrhotic individuals.

    Conclusions:

    • Treating insulin resistance in cirrhosis with agents like thiazolidinediones is a rational consideration.
    • Thiazolidinedione use is contraindicated in cirrhotic patients with limited liver function pending further safety data.
    • Further research is required to clarify the safety profile of thiazolidinediones in liver disease.