Impaired splanchnic and peripheral glucose uptake in liver cirrhosis.
OBJECTIVE
Patients with liver cirrhosis are insulin-resistant and frequently glucose-intolerant. Although peripheral glucose uptake has been shown to be impaired in liver cirrhosis, little is known about the significance of splanchnic (hepatic) glucose uptake after oral glucose load.


RESULTS
We performed an oral glucose tolerance test and euglycemic hyperinsulinemic clamp with oral glucose load for eight patients with liver cirrhosis and eight patients with chronic active hepatitis. The patients with liver cirrhosis had higher plasma glucose levels 2 h after glucose load than those with chronic active hepatitis (228+/-22 mg/dl vs. 102+/-9 mg/dl, p<0.01). Using the euglycemic hyperinsulinemic clamp with oral glucose load, we simultaneously measured peripheral and splanchnic glucose uptake. Peripheral glucose uptake in liver cirrhosis was 6.1+/-0.7 mg x kg(-1) x min(-1), which was lower than that in healthy volunteers (10.5+/-0.9 mg x kg(-1) x min(-1), p<0.05) and in chronic active hepatitis (8.4+/-0.3 mg x kg(-1) x min(-1), p<0.05). Furthermore, splanchnic glucose uptake in liver cirrhosis was much lower (20.1+/-3.4%) than in healthy volunteers (36.0+/-4.0%, p<0.05) and in chronic active hepatitis (37.2+/-3.1%, p<0.05).


CONCLUSIONS
These results suggest that glucose intolerance in patients with liver cirrhosis is caused by a defect of the glucose uptake of both splanchnic and peripheral tissues.
Imano
E
E
Department of Gastroenterology and Metabolic Disease, Osaka Prefectural General Hospital, Japan.
Kanda
T
T
Nakatani
Y
Y
Motomura
M
M
Arai
K
K
Matsuhisa
M
M
Yamasaki
Y
Y
Hori
M
M
D000284:Administration, Oral; D016022:Case-Control Studies; D005947:Glucose / Q000378:metabolism*; D018149:Glucose Intolerance; D005951:Glucose Tolerance Test; D006521:Hepatitis, Chronic / Q000378:metabolism; D006801:Humans; D007333:Insulin Resistance; D008099:Liver / Q000378:metabolism*; D008103:Liver Cirrhosis / Q000378:metabolism*; D008875:Middle Aged; D009132:Muscles / Q000378:metabolism; D013152:Splanchnic Circulation / Q000502:physiology*
D005947:Glucose