Insulin resistance as early sign of hepatic dysfunction in liver cirrhosis
Insulin resistance as early sign of hepatic dysfunction in liver cirrhosis
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DOI：
10.2152/jmi.61.180
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发表时间：
2014-02-01
影响因子：
0.7
通讯作者：
Takeda, Eiji
中科院分区：
文献类型：
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作者：
Taguchi, Kayo;Yamanaka-Okumura, Hisami;Takeda, Eiji
以餐后高血糖和高胰岛素血症为特征的糖耐量异常在肝硬化患者中较为常见。本研究旨在探讨LC患者糖耐量异常与肝功能异常的关系。对61例LC患者进行了75 g口服葡萄糖耐量试验（75 gOGTT）和0.2g/kg口服葡萄糖负荷联合高胰岛素正葡萄糖钳夹试验（HECGL）。61例LC患者根据75 g OGTT结果分为糖耐量正常组（LC-NGT）21例（34.4%）、糖耐量减低组（LC-IGT）12例（19.7%）和糖尿病组（LC-DM）28例（45.9%）。50例（82.0%）LC患者空腹血糖（FPG）正常。所有LC患者的外周（骨骼和脂肪）和肝组织HECGL评价的胰岛素抵抗，虽然没有观察到显着的葡萄糖耐受不良和肝功能障碍的严重程度之间的相关性。肝脏及周围组织胰岛素抵抗是LC的早期表现。这一事实表明，营养护理从早期阶段的LC患者将是必要的。
Glucose intolerance characterized by postprandial hyperglycemia and hyperinsulinemia is commonly seen in patients with liver cirrhosis (LC). The aim of this study is to clarify the relation between glucose intolerance and disorder of liver function in patients with LC. The 75 g oral glucose tolerance test (75 g OGTT) and the hyperinsulinemic euglycemic clamp combined with 0.2 g/kg oral glucose load (HECGL) were conducted in 61 patients with LC. Based on the results of 75 g OGTT, the 61 patients with LC were divided into groups, 21 (34.4%) patients with normal glucose tolerance (LC-NGT), 12 (19.7%) patients with impaired glucose tolerance (LC-IGT) and 28 (45.9%) patients with diabetes mellitus (LC-DM). Fasting plasma glucose (FPG) level was normal in 50 (82.0%) patients with LC. All patients with LC showed insulin resistance in both peripheral (skeletal and adipose) and hepatic tissues evaluated by HECGL, although significant correlation between the degree of glucose intolerance and the severity of hepatic dysfunction was not observed. Insulin resistance in both liver and peripheral tissues is the early sign in the patients with LC. This fact indicates that nutritional care from early stages of LC would be necessary in the patients.