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Insulin sensitivity in alcoholic cirrhosis
Scandinavian Journal of Clinical and Laboratory Investigation
|November 1, 1983
Summary
Patients with alcoholic cirrhosis show impaired glucose metabolism and reduced insulin sensitivity. This glucose intolerance stems from a disrupted pancreatic-hepatic-peripheral axis, not solely liver dysfunction.
Area of Science:
- Endocrinology
- Metabolic Disorders
- Hepatology
Background:
- Alcoholic cirrhosis is associated with metabolic disturbances.
- Understanding glucose metabolism in cirrhosis is crucial for patient management.
Purpose of the Study:
- To quantify glucose metabolism and insulin sensitivity in non-diabetic patients with alcoholic cirrhosis.
- To investigate the relationship between cirrhosis severity and glucose regulation.
Main Methods:
- Employed the 'glucose clamp technique' to measure glucose metabolic rate and insulin sensitivity.
- Assessed fasting glucose, insulin, and glucagon levels.
- Utilized hyperglycaemic and euglycaemic clamp protocols.
Main Results:
- Cirrhotic patients exhibited glucose intolerance, decreased insulin sensitivity, and hyperinsulinaemia.
- Insulin sensitivity remained consistent during both hyperglycaemic and euglycaemic clamps.
- Fasting glucagon levels were elevated and poorly suppressed by glucose or insulin.
Conclusions:
- Alcoholic cirrhosis leads to glucose intolerance characterized by impaired insulin sensitivity and abnormal insulin/glucagon secretion.
- The observed metabolic dysfunction appears linked to a disturbed pancreatic-hepatic-peripheral axis rather than direct liver function impairment.
- No correlation was found between clinical/biochemical data and the degree of glucose metabolism abnormality.