1 Liver disease, carbohydrate metabolism and diabetes

Shmueli, E.; Record, C. O.; Alberti, K. G. M. M.

doi:10.1016/s0950-351x(05)80163-6

Cited by 39 publications

(19 citation statements)

References 132 publications

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“…However, our patients with liver cirrhosis had increased circulating insulin levels on the one hand and increased adiponectin levels on the other. A large number of patients with liver cirrhosis develop insulin resistance (up to 80%) and diabetes (up to 15%) (28,31,39). Our findings, although not investigated directly in the present study, might indicate that the pathogenesis of insulin resistance and diabetes in cirrhosis differs from the mechanisms in patients without liver disease, consistent with previous reports (31,33,37).…”

Section: Discussionsupporting

confidence: 88%

Elevated circulating adiponectin levels in liver cirrhosis are associated with reduced liver function and altered hepatic hemodynamics

Tietge

Böker²,

Manns³

et al. 2004

American Journal of Physiology-Endocrinology and Metabolism

137

130

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. Elevated circulating adiponectin levels in liver cirrhosis are associated with reduced liver function and altered hepatic hemodynamics. Am J Physiol Endocrinol Metab 287: E82-E89, 2004. First published March 9, 2004; 10.1152/ajpendo.00494.2003Adiponectin is a novel adipocytokine negatively correlated with parameters of the metabolic syndrome, such as body mass index (BMI), body fat mass (BFM), and circulating insulin levels. Furthermore, metabolic actions directly on the liver have been described. The aim of the present study was to characterize circulating adiponectin levels, hepatic turnover, and the association of adiponectin with key parameters of hepatic as well as systemic metabolism in cirrhosis, a catabolic disease. Circulating adiponectin levels and hepatic turnover were investigated in 20 patients with advanced cirrhosis. Hepatic hemodynamics [portal pressure, liver blood flow, hepatic vascular resistance, indocyanine green (ICG) half-life], body composition, resting energy expenditure, hepatic free fatty acids (FFA) and glucose turnover, and circulating levels of hormones (catecholamines, insulin, glucagon) and proinflammatory cytokines (IL-1␤, TNF-␣, IL-6) were also assessed. Circulating adiponectin increased dependently on the clinical stage in cirrhosis compared with controls (15.2 Ϯ 1.7 vs. 8.2 Ϯ 1.1 g/ml, respectively, P Ͻ 0.01), whereas hepatic extraction decreased. Adiponectin was negatively correlated with parameters of hepatic protein synthesis (prothrombin time: r ϭ Ϫ0.62, P ϭ 0.003; albumin: r ϭ Ϫ0.72, P Ͻ 0.001) but not with transaminases or parameters of lipid metabolism. In addition, circulating adiponectin increased with portal pressure (r ϭ 0.67, P ϭ 0.003), hepatic vascular resistance (r ϭ 0.60, P ϭ 0.008), and effective hepatic blood flow (ICG half-life: r ϭ 0.69, P ϭ 0.001). Adiponectin in cirrhosis was not correlated with BMI, BFM, parameters of energy metabolism, insulin levels, hepatic FFA and glucose turnover, and circulating proinflammatory cytokines. These results demonstrate that 1) adiponectin plasma levels in cirrhosis are significantly elevated, 2) the liver is a major source of adiponectin extraction, and 3) adiponectin levels in cirrhosis do not correlate with parameters of body composition or metabolism but exclusively with reduced liver function and altered hepatic hemodynamics. hepatic turnover; hepatic venous pressure gradient; calorimetry; body composition ADIPONECTIN IS A RECENTLY DISCOVERED 244 amino acid-containing molecule that belongs to the group of adipocytokines. It has been identified by several different groups and is thus also referred to as adipocyte complement-related protein 30

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Section: Discussionsupporting

confidence: 88%

Elevated circulating adiponectin levels in liver cirrhosis are associated with reduced liver function and altered hepatic hemodynamics

Tietge

Böker²,

Manns³

et al. 2004

American Journal of Physiology-Endocrinology and Metabolism

137

130

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“…Approximately one-half to two-third of patients with liver cirrhosis showed glucose intolerance after an oral glucose load (Megyesi et al, 1967;Shmueli et al, 1992). Petrides and DeFronzo (1989) reported that the non-oxidative glucose disposal rate is reduced by 50% in cirrhotic patients.…”

Section: Discussionmentioning

confidence: 99%

Effect of late evening snack with rice ball on energy metabolism in liver cirrhosis

et al. 2006

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Objective: This study investigates the effects of a late evening snack (LES), of 200 kcal of rice ball, on energy metabolism in cirrhotic patients. Impaired nutritional metabolism has been associated with cirrhosis, and frequent intake of small meals may prevent early-onset starvation, and maintain nourishment in these patients. Subjects: Twenty-one cirrhotic patients and 26 control subjects (Control) were recruited for this study. Patients were subsequently treated by LES (LC-LES) and by a non-LES regimen (LC-NLES).Method: Resting energy expenditure and respiratory quotient (RQ) were assessed by indirect calorimetry at 0830, 1130 and 1430. Blood glucose and non-esterified fatty acids (NEFA) were measured just before the energy metabolism measurements. The regular diet included three major meals and LES, at 0900, 1200, 1800 and 2100, respectively. The Control and LC-NLES groups received only the major meals, whereas the LC-LES group received three meals plus 200 kcal LES for 7 days. There was no difference in the total energy intake among Control, LC-NLES and LC-LES groups. Results: Respiratory quotient in LC-NLES was significantly lower than that of Control at 0830. Respiratory quotient value in LC-LES significantly elevated from that in LC-NLES. The RQ values did not differ among Control, LC-NLES and LC-LES at 2 h after the meal (1130 and 1430). Non-esterified fatty acids in LC-LES were lower than that in LC-NLES after overnight fasting. Conclusions: The ingestion of a 200 kcal rice ball LES can improve the nutritional metabolism in cirrhotic patients.

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“…These different expression patterns possibly translate into different biological properties of resistin in rodents and humans (43). However, studies conducted so far (13, 43) implicate resistin in 1) the regulation of adipose tissue mass; 2) glucose homeostasis, particularly insulin resistance; and 3) inflammation.Liver cirrhosis is a catabolic disease characterized by 1) decreased adipose tissue mass (24, 26), 2) a high incidence of insulin resistance and diabetes (31,40,48), and 3) a proinflammatory state as represented by elevated cytokine levels (22,49). Patients with liver cirrhosis display disturbances of glucose metabolism with 60 -80% having impaired glucose tolerance (IGT) and 10 -15% developing overt diabetes (31, 40).…”

mentioning

confidence: 99%

“…Patients with liver cirrhosis display disturbances of glucose metabolism with 60 -80% having impaired glucose tolerance (IGT) and 10 -15% developing overt diabetes (31,40). Cirrhosis-associated IGT is characterized by hyperinsulinemia and peripheral insulin resistance (16,25), whereas a reduced insulin secretory capacity appears to eventually cause the development of overt diabetes (31,29).…”

mentioning

confidence: 99%

Elevated resistin levels in cirrhosis are associated with the proinflammatory state and altered hepatic glucose metabolism but not with insulin resistance

Bahr

Ockenga²,

Böker³

et al. 2006

American Journal of Physiology-Endocrinology and Metabolism

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. Elevated resistin levels in cirrhosis are associated with the proinflammatory state and altered hepatic glucose metabolism but not with insulin resistance. Am J Physiol Endocrinol Metab 291: E199 -E206, 2006. First published February 14, 2005 doi:10.1152/ajpendo.00291.2005.-The adipokine resistin has been implicated in obesity and insulin resistance. Liver cirrhosis is associated with decreased body fat mass and insulin resistance. We determined plasma resistin levels in 57 patients with cirrhosis, 13 after liver transplantation, and 30 controls and correlated these with hemodynamic as well as hepatic and systemic metabolic parameters. Patients with cirrhosis had, dependent on the clinical stage, an overall 86% increase in resistin levels (P Ͻ 0.001) with hepatic venous resistin being higher than arterial levels (P Ͻ 0.001). Circulating resistin was significantly correlated with plasma TNF-␣ levels (r ϭ 0.62, P Ͻ 0.001). No correlation was observed between resistin and hepatic hemodynamics, body fat mass, systemic energy metabolism, and the degree of insulin resistance. However, plasma resistin in cirrhosis was negatively associated with hepatic glucose production (r ϭ Ϫ0.47, P Ͻ 0.01) and positively with circulating free fatty acids (FFA; r ϭ 0.40, P Ͻ 0.01) and ketone bodies (r ϭ 0.48, P Ͻ 0.001) as well as hepatic ketone body production (r ϭ 0.40, P Ͻ 0.01). After liver transplantation, plasma resistin levels remained unchanged, whereas insulin resistance was significantly improved (P Ͻ 0.01). These data provide novel insights into the role of resistin in the pathophysiological background of a catabolic disease in humans and also indicate that resistin inhibition may not represent a suitable therapeutic strategy for the treatment of insulin resistance and diabetes in patients with liver cirrhosis. hepatic turnover; body composition; liver; portal pressure RESISTIN IS A RECENTLY IDENTIFIED ϳ12-kDa adipokine with a proposed role in obesity and insulin resistance, key features of the metabolic syndrome (9,15,42). In rodents, resistin is almost exclusively expressed in adipocytes (13, 43), whereas in humans resistin expression is hardly detectable in adipocytes and is mostly found in monocytes/macrophages (19,37,43). These different expression patterns possibly translate into different biological properties of resistin in rodents and humans (43). However, studies conducted so far (13, 43) implicate resistin in 1) the regulation of adipose tissue mass; 2) glucose homeostasis, particularly insulin resistance; and 3) inflammation.Liver cirrhosis is a catabolic disease characterized by 1) decreased adipose tissue mass (24, 26), 2) a high incidence of insulin resistance and diabetes (31,40,48), and 3) a proinflammatory state as represented by elevated cytokine levels (22,49). Patients with liver cirrhosis display disturbances of glucose metabolism with 60 -80% having impaired glucose tolerance (IGT) and 10 -15% developing overt diabetes (31, 40). Cirrhosis-associated IGT is characterized by hyperinsulinemia and per...

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1 Liver disease, carbohydrate metabolism and diabetes

Cited by 39 publications

References 132 publications

Elevated circulating adiponectin levels in liver cirrhosis are associated with reduced liver function and altered hepatic hemodynamics

Elevated circulating adiponectin levels in liver cirrhosis are associated with reduced liver function and altered hepatic hemodynamics

Effect of late evening snack with rice ball on energy metabolism in liver cirrhosis

Elevated resistin levels in cirrhosis are associated with the proinflammatory state and altered hepatic glucose metabolism but not with insulin resistance

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