title: Major liver resection results in early exacerbation of insulin resistance, and may be a risk factor of developing overt diabetes in the future.
abstract: OBJECTIVE
  This single center prospective cohort study evaluated the influence of hemihepatectomy on glucose homeostasis.
  
  
  METHODS
  The study included 30 patients undergoing hemihepatectomy. All patients underwent an oral 75 g glucose tolerance test before (baseline), 1 week and 1 month after the surgery. Plasma glucose, insulin and glucagon were measured in the OGTT samples, and the HOMA index was calculated. The fasting levels of interleukin 6 and 1β, tumor necrosis factor and adiponectin were assessed.
  
  
  RESULTS
  The fasting plasma and 120-min post-challenge mean glucose level increased during the study from 89.6 to 103.5 mg/dl (by 15.5 %) and from 136.4 to 162.2 (by 18.9 %; p = 0.51), respectively, accompanied by an increase in fasting glucagon (from 3.2 to 5.9 ng/mL; p = 0.043) and insulin (from 14.6 to 19.3 IU/mL) and by a decrease in plasma insulin at 60 min of OGTT (p = 0.34). An increase of IL-6 (p = 0.015) and TNF (from 49.7 to 53 pg/mL), and decrease of plasma APO (7658 to 5152 ng/mL) and exacerbation of insulin resistance (p = 0.007) were noted.
  
  
  CONCLUSIONS
  Hemihepatectomy resulted in moderate disturbances in glucose homeostasis, in a majority of patients that was likely to be of minor clinical relevance. However, the patients might be at higher risk of developing overt diabetes following long-term survival.
authors: Department of General and Transplant Surgery, Barlicki University Hospital, Medical University of Lodz, Kopcinskiego Street 22, 90-153 Lodz, Poland. A.Durczynski@interia.pl
authors: Adam
authors: A
authors: Durczynski
authors: Janusz
authors: J
authors: Strzelczyk
authors: Katarzyna
authors: K
authors: Wojciechowska-Durczynska
authors: Anna
authors: A
authors: Borkowska
authors: Piotr
authors: P
authors: Hogendorf
authors: Dariusz
authors: D
authors: Szymanski
authors: Justyna
authors: J
authors: Chalubinska
authors: Leszek
authors: L
authors: Czupryniak
mesh_terms: D052242:Adiponectin / Q000097:blood; D000368:Aged; D001786:Blood Glucose / Q000378:metabolism; D015331:Cohort Studies; D003920:Diabetes Mellitus / Q000209:etiology*; D018450:Disease Progression; D005260:Female; D005934:Glucagon / Q000097:blood; D005951:Glucose Tolerance Test; D006498:Hepatectomy / Q000009:adverse effects*; D006706:Homeostasis; D006801:Humans; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance / Q000502:physiology*; D015850:Interleukin-6 / Q000097:blood; D008113:Liver Neoplasms / Q000150:complications* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012306:Risk; D013997:Time Factors; D014409:Tumor Necrosis Factor-alpha / Q000097:blood
chemical_list: D052242:Adiponectin; D001786:Blood Glucose; D007328:Insulin; D015850:Interleukin-6; D014409:Tumor Necrosis Factor-alpha; D005934:Glucagon