Effects of a glucose meal on energy metabolism in patients with cirrhosis before and after liver transplantation.
OBJECTIVE
Liver transplantation results in hepatic denervation. This may produce alterations of liver energy and substrate metabolism, which may contribute to weight gain after liver transplantation.


METHODS
Prospective clinical study.


METHODS
Liver transplantation clinics in a university hospital.


METHODS
Seven nondiabetic patients with cirrhosis were recruited while on a waiting list for liver transplantation. Seven healthy subjects were recruited as controls.


METHODS
Orthotopic liver transplantation.


METHODS
Evaluation of energy and substrate metabolism after ingestion of a glucose load with indirect calorimetry was performed before, 2 to 6 weeks after, and 5 to 19 months after transplantation. Whole-body glucose oxidation and storage and glucose-induced thermogenesis were calculated.


RESULTS
Patients with cirrhosis had modestly elevated resting energy expenditure and normal glucose-induced thermogenesis and postprandial glucose oxidation and storage. These measures remained unchanged after liver transplantation despite a significant increase in postprandial glycemia. Patients, however, gained an average of 3 kg of body weight after 5 to 19 months compared with their weight before transplantation.


CONCLUSIONS
Liver denervation secondary to transplantation does not lead to alterations of energy metabolism after ingestion of a glucose load.
Tappy
L
L
Institut de physiologie, 7 rue du Bugnon, CH-1005 Lausanne, Switzerland. Luc.Tappy@iphysiol.unil.ch
Schneiter
P
P
Chioléro
R
R
Bettschart
V
V
Gillet
M
M
D001786:Blood Glucose / Q000032:analysis; D016022:Case-Control Studies; D004734:Energy Metabolism; D005260:Female; D005500:Follow-Up Studies; D005947:Glucose / Q000493:pharmacokinetics / Q000494:pharmacology*; D006801:Humans; D008099:Liver / Q000294:innervation / Q000378:metabolism; D008103:Liver Cirrhosis / Q000378:metabolism* / Q000601:surgery*; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D011300:Preoperative Care; D011446:Prospective Studies; D013997:Time Factors; D015430:Weight Gain
D001786:Blood Glucose; D005947:Glucose