7Carbohydrate metabolism in liver disease

Johnston, Desmond G.; Alberti, K. G. M. M.

doi:10.1016/s0300-595x(76)80046-1

Cited by 31 publications

(7 citation statements)

References 103 publications

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“…The authors suggest that the finding of more than mild disturbance of routine liver function in diabetic patients should prompt investigation just as in nondiabetic patients. Disturbance of metabolic functions of the liver appear to correlate with routine liver function tests (Johnston and Alberti, 1976) and thus impairment of the metabolic capacity of the liver is unlikely to contribute significantly to poor control of diabetes in the majority of diabetics. None of the patients reported in this study had symptoms of uncontrolled diabetes although in some cases control was not satisfactory.…”

Section: Discussionmentioning

confidence: 99%

“…The liver is probably the single most important regulatory site of glucose metabolism (Felig and Sherwin, 1976) and, in patients with liver disease, disturbance of carbohydrate metabolism is common (Johnston and Alberti, 1976). Various authors have reported a prevalence of cirrhosis in diabetics from 6 to 21 % Correspondence: R. Wright, Professorial Medical Unit, Level F, Centre Block, Southampton General Hospital, Tremona Road, Southampton S09 4XY at post-mortem (Creutzfeld, Frerichs and Sickinger, 1970), but it is likely that this figure is falsely elevated by inclusion of patients with hepatogenous diabetes whose prognosis may be very different from that of those with 'genetic' diabetes mellitus (Felig and Sherwin, 1976).…”

Section: Introductionmentioning

confidence: 99%

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Liver disease in patients with diabetes mellitus

Foster¹,

Griffith²,

Dewbury³

et al. 1980

Postgraduate Medical Journal

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SummaryLiver function tests were assessed in 60 unselected out-patient diabetics stabilized on insulin or oral hypoglycaemic agents. Routine liver function tests, particularly plasma concentrations of y-glutamyl transpeptidase and alkaline phosphatase were elevated occasionally but rarely to more than twice the upper limit of normal. There was no correlation between measures of diabetic control and results of liver function tests. Twelve (20 %) patients had evidence of gall stones, a prevalence above the expected from the community. Fourteen (23%) patients had an abnormally bright liver ultrasound echo pattern, probably indicative of fatty infiltration of the liver. This echo pattern was associated with only a minimal rise in plasma alanine amino transferase and alkaline phosphatase concentrations. It is concluded that functionally significant liver disease is uncommon amongst stabilized diabetic patients.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Liver disease in patients with diabetes mellitus

Foster¹,

Griffith²,

Dewbury³

et al. 1980

Postgraduate Medical Journal

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“…Its mechanisms are not known but are often associated with abnormalities in the metabolism of insulin, glucagon, and growth hormone. 51 Most drugs are metabolized by the hepatic microsomal enzyme system, the terminal component in this process being cytochrome P-450, a heterogenous group of hemop rote ins. 52 " 54 According to present opinion, a drug combines to the binding sites of P-450 before being oxidized to a metabolite.…”

Section: Discussionmentioning

confidence: 99%

The Evaluation of the Drug-metabolizing Capacity in Patients with Diabetes Mellitus

Pelkonen

1980

Diabetes

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Hepatic drug-metabolizing capacity was investigated in 56 diabetics. The antipyrine test was selected as an in vivo index, since its kinetics indirectly reflect the metabolically active liver mass. Hepatic cytochrome P-450 (P-450), determined from the biopsy samples, was used as an in vitro parameter, since it is a direct measure of microsomal drug-metabolizing enzyme activity. There was a wide interindividual variation in the indexes of drug metabolism in the diabetics: 40 fold in P-450 content and eightfold in antipyrine metabolism. P-450 levels were higher and antipyrine metabolism faster in the subjects with normal liver than in those with fatty liver, parenchymal inflammatory changes, or cirrhosis. Thus the in vivo and in vitro parameters of drug metabolism were related to the alterations in liver histology. On the other hand, the diabetes per se did not seem to alter the drug-metabolizing capacity of the liver. Also, drug metabolism in diabetics classified by treatment regimen did not differ significantly.

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“…Liver injury has been associated with de creased microsomal glucose metabolism and drug-metabolizing enzyme activity [Hickenbottom and Hornbrook, 1971;Plaa and Witschi, 1976;Johnston and Alberti, 1976;So-be reflected in the other system, e.g. activa tion of liver drug hydroxylating capacity might alter the hepatic handling of glucose.…”

Section: Introductionmentioning

confidence: 99%

Effects of Medroxyprogesterone Acetate on Hepatic Glucose Metabolism and Microsomal Enzyme Activity in Rats with Normal and Altered Liver

Stengård¹,

Saarni

Sotaniemi³

1984

Pharmacology

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Effects of medroxyprogesterone acetate (MPA) on hepatic glucose handling and drug metabolism were investigated in female rats with intact and damaged liver. Hepatic glucose-6-phosphatase activity, glycogen content and fasting blood glucose were assessed as indices of glucose metabolism. Cytochrome P-450 content and NADPH-cytochrome P-450 reductase activity were assayed to reflect liver drug metabolism. Liver injury was induced by dimethylnitrosamine and carbon tetrachloride. The results demonstrate that hepatic glucose handling and drug metabolism were changed in a parallel fashion in intact, damaged and induced liver. The MPA-induced changes in glucose metabolism were slight in intact animals, whereas the compound has an increasing effect on glucose and drug metabolism in rats with damaged liver. The findings demonstrate that MPA enhances the normalization of hepatic glucose and drug metabolism in damaged liver.

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7Carbohydrate metabolism in liver disease

Cited by 31 publications

References 103 publications

Liver disease in patients with diabetes mellitus

Liver disease in patients with diabetes mellitus

The Evaluation of the Drug-metabolizing Capacity in Patients with Diabetes Mellitus

Effects of Medroxyprogesterone Acetate on Hepatic Glucose Metabolism and Microsomal Enzyme Activity in Rats with Normal and Altered Liver

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