The role of insulin and glucagon in the plasma aminoacid imbalance of chronic hepatic encephalopathy.
Increased glucagon (IRG) levels have been documented in liver cirrhosis, particularly associated with portal-systemic shunting. In spite of increased insulin (IRI) levels, IRI/IRG are reduced. This alteration has been proposed to have a pathogenic role in plasma aminoacid imbalance which seems to account for hepatic encephalopathy. We studied IRG and IRI/IRG in 13 controls and in 3 groups of cirrhotics, divided on the basis of their mental state. Glucagon was determined by means of 30 K Unger's antibody; insulin by a double antibody technique. Results are expressed in the table as means +/- SEM. (Formula: see text)A progressive increase in IRG secretion is present in cirrhotics and correlates with the mental state; IRI/IRG is not altered in cirrhosis until neurological distrubances are present. A relative fall in IRI which can no more balance the increasing IRG values characterizes hepatic encephalopathy.
D000596:Amino Acids / Q000097:blood; D000597:Amino Acids, Branched-Chain / Q000378:metabolism; D000818:Animals; D001786:Blood Glucose / Q000032:analysis; D004285:Dogs; D005934:Glucagon / Q000378:metabolism*; D006501:Hepatic Encephalopathy / Q000378:metabolism*; D006801:Humans; D007328:Insulin / Q000378:metabolism*; D007532:Isoleucine / Q000378:metabolism; D007930:Leucine / Q000378:metabolism; D014364:Tryptophan / Q000378:metabolism; D014443:Tyrosine / Q000378:metabolism; D014633:Valine / Q000378:metabolism
D000596:Amino Acids; D000597:Amino Acids, Branched-Chain; D001786:Blood Glucose; D007328:Insulin; D007532:Isoleucine; D014443:Tyrosine; D014364:Tryptophan; D005934:Glucagon; D007930:Leucine; D014633:Valine