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Pancreatic hormone changes in infantile obstructive jaundice
11st Department of Surgery, Hokkaido University School of Medicine, Sapporo, Japan.
Insights
Obstructive jaundice in infants can disrupt pancreatic hormones. Plasma glucagon levels rise with worsening liver damage in congenital biliary atresia, indicating metabolic disturbances.
Area of Science:
- Endocrinology
- Pediatric Gastroenterology
- Hepatology
Background:
- Obstructive jaundice in infancy can lead to metabolic disturbances.
- Pancreatic hormones, insulin and glucagon, play crucial roles in metabolic regulation.
- Understanding these hormonal changes is vital for managing infant liver conditions.
Purpose of the Study:
- To evaluate metabolic disturbances of pancreatic hormones in infantile obstructive jaundice.
- To investigate the relationship between hormone levels and liver damage severity.
Main Methods:
- Experimental study using young rats with ligated common bile ducts.
- Clinical evaluation of plasma insulin (IRI) and glucagon (IRG) levels in infants.
- Correlation analysis of hormone levels with hepatic fibrosis grading in congenital biliary atresia (CBA).
Main Results:
- In rats, plasma insulin levels slightly decreased while plasma glucagon increased significantly 4 weeks post-ligation.
- No significant IRI or IRG differences were found in infants with neonatal hepatitis or CBA compared to controls.
- In CBA patients, increased IRG and decreased IRI/IRG ratio correlated with advanced hepatic fibrosis (grade III).
Conclusions:
- Obstructive jaundice in infancy is associated with altered pancreatic hormone levels.
- Plasma glucagon concentration increases with the severity of liver damage in obstructive jaundice.
- Hormonal changes, particularly elevated glucagon, may serve as indicators of hepatic fibrosis progression.
Abstract:
Metabolic disturbances of pancreatic hormones in obstructive jaundice in infancy were evaluated experimentally and clinically. In our experimental study, using young rats, the level of plasma insulin (IRI) gradually increased after ligation of the common bile duct. These levels were a little lower than those in the non-treated controls. The level of plasma glucagon (IRG) increased remarkably 4 weeks after ligation of the common bile duct. Clinically, there were no significant differences in the levels of IRI and IRG among normal controls and cases of neonatal hepatitis and congenital biliary atresia (CBA). In CBA patients, these levels can be correlated with the progression of hepatic fibrosis; an increase in IRG and a decrease in the IRI/IRG mol ratio was noticed in patients with grade III of hepatic fibrosis. These results indicate that, in obstructive jaundice in infancy, the more severe the hepatic damage due to obstructive jaundice, the higher the level of plasma glucagon concentration will rise.