Altered postprandial glucose, insulin, leptin, and ghrelin in liver cirrhosis: correlations with energy intake and resting energy expenditure

Kalaitzakis, Evangelos; Bosæus, Ingvar; Öhman, Lena; Bjõrnsson, Einar

doi:10.1093/ajcn/85.3.808

Cited by 74 publications

(60 citation statements)

References 38 publications

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“…The severity of liver disease was (median and range), according to ChildPugh: 9 (5-12) and the MELD: 14 (7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23). Albumin (median and range) was decreased in liver failure patients when compared with the Cont group, 3.0 (2.6-4.6) vs 4.1 (3.4-5.3) g/dl, PZ0.009.…”

Section: Resultsmentioning

confidence: 95%

“…Ghrelin levels did not correlate with liver function. Other studies have found normal ghrelin levels (18,19,21). Kalaitzakis et al (19) found that patients with cirrhosis had similar fasting ghrelin levels to a Cont group.…”

Section: Discussionmentioning

confidence: 92%

“…Other studies have found normal ghrelin levels (18,19,21). Kalaitzakis et al (19) found that patients with cirrhosis had similar fasting ghrelin levels to a Cont group. In contrast, patients with cirrhosis had higher postprandial glucose and lower ghrelin concentrations at 4 h postprandially than the Cont subjects.…”

Section: Discussionmentioning

confidence: 92%

“…Normal, increased, and decreased ghrelin levels have been found in hepatic failure patients (18,(19)(20)(21)(22)(23). We have previously found significantly decreased fasting and post-OGTT plasma ghrelin levels in patients with liver failure who were candidates for transplantation when compared with control subjects (Cont) (24).…”

Section: Introductionmentioning

confidence: 94%

“…In fact, most of the leading studies on the correlation between metabolic disturbances and ghrelin have focused on the estimation of total ghrelin (10,11,(13)(14)(15), and there are concerns about the specificity of available acylghrelin assays (17). We focused on measuring total ghrelin, with the aim of comparing our data with the discrepant total ghrelin levels that have been found in hepatic failure patients in different studies (18)(19)(20)(21)(22)(23)(24).…”

Section: Introductionmentioning

confidence: 99%

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Altered fasting and postprandial plasma ghrelin levels in patients with liver failure are normalized after liver transplantation

Diz-Lois

García-Buela²,

Suárez³

et al. 2010

European Journal of Endocrinology

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Context: Anorexia is a problem of paramount importance in patients with advanced liver failure. Ghrelin has important actions on feeding and weight homeostasis. Experimental data exist, which suggest that ghrelin could protect hepatic tissue. Both fasting and post-oral glucose tolerance test (OGTT) ghrelin concentrations are controversial in liver cirrhosis and are unknown after liver transplantation. Objective: Our aim was to study fasting ghrelin concentrations and their response to an OGTT in liver failure patients before and after liver transplantation. Design and methods: We included 21 patients with severe liver failure studied before (pretransplantation, PreT) and 6 months after liver transplantation (posttransplantation, PostT), and 10 age-and body mass index-matched healthy or overweight subjects as the control group (Cont). After an overnight fast, 75 g of oral glucose were administered; glucose, insulin, and ghrelin were obtained at baseline and at times 30, 60, 90, and 120 min.

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Section: Resultsmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 92%

Section: Discussionmentioning

confidence: 92%

Section: Introductionmentioning

confidence: 94%

Section: Introductionmentioning

confidence: 99%

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Altered fasting and postprandial plasma ghrelin levels in patients with liver failure are normalized after liver transplantation

Diz-Lois

García-Buela²,

Suárez³

et al. 2010

European Journal of Endocrinology

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U‐shaped relationship between subcutaneous adipose tissue index and mortality in liver cirrhosis

Zhu

Yin

et al. 2022

J cachexia sarcopenia muscle

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Background Subcutaneous and visceral adipose tissues are important body components, but their effects on the mortality in patients with liver cirrhosis remain controversial based on the current evidence. Methods We retrospectively identified 372 eligible patients in whom subcutaneous adipose tissue index (SATI) and visceral adipose tissue index (VATI) could be measured by computed tomography images at the third lumbar vertebra. The association of SATI and VATI with the risk of death was evaluated on a continuous scale with restricted cubic spline curves based on Cox proportional hazards models. Cumulative probability of mortality was estimated by Nelson–Aalen cumulative risk curve analyses. Independent predictors of death were evaluated by competing risk analyses after adjusting for age, sex, and model for end‐stage liver disease score. Results Majority of patients were male (69.4%) with a mean age of 55.40 ± 10.68 years. SATI had a U‐shaped association with mortality (P for non‐linearity <0.001). Cutoff values of SATI were 19.7 and 51.8 cm2/m2 at the points where hazard ratios were just <1.2. SATI was categorized as low (<19.7 cm2/m2), moderate (19.7–51.8 cm2/m2), and high (>51.8 cm2/m2) level. There was no significant difference in the cumulative probability of mortality between low versus moderate SATI groups (Gray's test, P = 0.052) and high versus moderate SATI groups (Gray's test, P = 0.054). Competing risk analyses demonstrated that low SATI could increase the mortality compared with moderate SATI (subdistribution hazard ratio [sHR] = 1.66, 95% confidence interval [CI]: 0.992–2.78, P = 0.054) and was an independent predictor of death (sHR = 1.86, 95% CI: 1.059–3.28, P = 0.031). Competing risk analyses also demonstrated that high SATI could significantly increase the mortality compared with moderate SATI (sHR = 1.6, 95% CI: 1–2.54, P = 0.049), and was an independent predictor of death (sHR = 2.007, 95% CI: 1.195–3.37, P = 0.0085). VATI had an irregularly shaped association with mortality (P for non‐linearity <0.001). Cutoff values of VATI were 9.8 and 40.2 cm2/m2 at the points where hazard ratios were just <1.2. VATI was categorized as low (<9.8 cm2/m2), moderate (9.8–40.2 cm2/m2), and high (>40.2 cm2/m2) level. There was no significant difference in the cumulative probability of mortality between low versus moderate VATI groups (Gray's test, P = 0.381) and high versus moderate VATI groups (Gray's test, P = 0.787). Competing risk analyses demonstrated that neither low (sHR = 1.27, 95% CI: 0.599–2.7, P = 0.53) nor high VATI (sHR = 0.848, 95% CI: 0.539–1.34, P = 0.48) was an independent predictor of death compared with moderate VATI. Conclusions Both excessive deficiency and accumulation of subcutaneous adipose tissues negatively influence the outcomes of cirrhotic patients.

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Energy Expenditure and Liver Transplantation: What We Know and Where We Are

Santos

Correia

Anastácio

2020

J Parenter Enteral Nutr

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Patients with end‐stage liver disease (ESLD) and undergoing liver transplantation (LTx) commonly present with malnutrition attributed to various etiologies. One of the causes is potential hypermetabolism resulting from increased resting energy expenditure (REE). After the surgery, it is hypothesized that these patients show a reduction in REE, which may contribute to the weight gain observed in this population. However, there have been controversial results regarding the metabolic status of ESLD patients and liver recipients, which has led us to critically review the pertinent literature. We enrolled studies with the following goals: assessment of REE of these patients either before or after surgery by using indirect calorimetry (measured REE [mREE]) and comparison of these mREE values with those of healthy controls or with REE values obtained using predictive equations (predicted REE [pREE]). For most patients, mREE and pREE values were comparable. However, ≥5.3% of patients exhibited hypermetabolism when the mREE was compared with the pREE using the Harris‐Benedict formula. Three follow‐up studies that were conducted postsurgery showed a progressive reduction in the mREE for ≤1 year. However, conflicting data have been published, and cross‐sectional studies have not reported hypometabolic patients. In conclusion, there is no consensus regarding the metabolic status of pre‐LTx and post‐LTx patients, which may be due to differences in the methods used for comparison. Therefore, we highlight this aspect of LTx patient management, which impacts the quality of nutrition therapy required by these patients.

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Altered postprandial glucose, insulin, leptin, and ghrelin in liver cirrhosis: correlations with energy intake and resting energy expenditure

Cited by 74 publications

References 38 publications

Altered fasting and postprandial plasma ghrelin levels in patients with liver failure are normalized after liver transplantation

Altered fasting and postprandial plasma ghrelin levels in patients with liver failure are normalized after liver transplantation

U‐shaped relationship between subcutaneous adipose tissue index and mortality in liver cirrhosis

Energy Expenditure and Liver Transplantation: What We Know and Where We Are

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