Metabolic, endocrine, haemodynamic and pulmonary responses to different types of exercise in individuals with normal or reduced liver function

Müller, Manfred J.; Dettmer, A; Tettenborn, M.; Radoch, E.; Fichter, J; Wagner, Thomas; Balks, H. J.; Mühlen, A. von zur; Selberg, O.

doi:10.1007/bf00377447

Cited by 18 publications

(10 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In cirrhotic patients isokinetic muscle strength and work capacity have been found to be severely reduced. [1][2][3][4][5][6] Fatigue and loss of muscle strength can be related to both central and peripheral phenomena. [7][8][9] The central components are largely unknown, but probably include psychologic factors such as the mental condition and motivation of the person, as well as metabolic disturbances, e.g., hypoglycemia, hyperammoniemia, and changes in amino acid composition.…”

mentioning

confidence: 99%

Reduced Mitochondrial Adenosine Triphosphate Synthesis in Skeletal Muscle in Patients With Child–Pugh Class B and C Cirrhosis

et al. 2001

View full text Add to dashboard Cite

Patients with cirrhosis of the liver often complain of tiredness and a lack of strength at physical exercise. Other investigators have found that muscle strength, work capacity, and maximal oxygen consumption are reduced in cirrhosis. We hypothesized that mitochondrial maximal rate of ATP synthesis in skeletal muscle may be impaired in these patients. This was tested with 31 P nuclear magnetic resonance spectroscopy in anterior tibial muscle of cirrhotic patients and healthy controls at rest, during exercise, and subsequent recovery. In patients with Child-Pugh class B and C cirrhosis resting PCr/P i ratio (8.3 ؎ 1.0; n ‫؍‬ 7) was lower than in patients with Child-Pugh class A cirrhosis (12.1 ؎ 2.1; n ‫؍‬ 7) and controls (11. 7 ؎ 1.1; n ‫؍‬ 6; P ‫؍‬ .03), while the resting P i /␥ATP ratio was higher in Child-Pugh class B and C patients (0.43, 0.30, and 0.27, respectively; P ‫؍‬ .03). Maximal rate of mitochondrial adenosine triphosphate ( Patients with cirrhosis often complain of tiredness and weakness at physical exercise. In cirrhotic patients isokinetic muscle strength and work capacity have been found to be severely reduced. [1][2][3][4][5][6] Fatigue and loss of muscle strength can be related to both central and peripheral phenomena. 7-9 The central components are largely unknown, but probably include psychologic factors such as the mental condition and motivation of the person, as well as metabolic disturbances, e.g., hypoglycemia, hyperammoniemia, and changes in amino acid composition. 9 In cirrhosis the peripheral components possibly include decreased skeletal muscle mass, hemodynamic changes, decreased hepatic glycogenolysis, and insulin resistance. 10 There may, however, also be more fundamental metabolic changes such as impaired mitochondrial function. It appears that in cirrhosis maximal oxygen consumption is decreased, 2,3 which at least to some extent is a result of the decreased muscle mass in the cirrhotic patients, but which may also be the result of decreased mitochondrial oxidative capacity and/or reduced number of mitochondria in the muscle tissue. In accordance with this notion the content of adenosine triphosphate (ATP), phosphocreatine (PCr), and total Mg 2ϩ were reported to be decreased in biopsy specimens of skeletal muscle in patients with cirrhosis. 11-13 A reduced ATP/ ADP ratio was also found. 11,12 In contrast to the static data available after biopsy the technique of 31 P nuclear magnetic resonance spectroscopy (NMRS) allows a dynamic examination of the relative concentrations of ATP, PCr, and inorganic phosphorus (P i ) at rest, during, and after exercise. We used this technique to study the hypothesis that mitochondrial capacity for ATP synthesis is reduced in the skeletal muscle of the cirrhotic patient. The study indicated that this was indeed the case for patients with cirrhosis of Child-Pugh class B and C. PATIENTS AND METHODSThe study included 14 patients with stable cirrhosis of the liver. Clinical data are shown in Table 1. The controls were 6 healthy individuals with simil...

show abstract

mentioning

confidence: 99%

Reduced Mitochondrial Adenosine Triphosphate Synthesis in Skeletal Muscle in Patients With Child–Pugh Class B and C Cirrhosis

et al. 2001

View full text Add to dashboard Cite

show abstract

“…Decreased carbohydrate stores in the liver and muscle are due to accelerated glycogenolysis and impaired glycogenesis as the result of increased insulin insensitivity 2122 Recent studies have shown that muscle glycogen content in patients with liver cirrhosis is positively correlated with the resting whole body respiratory quotient,15 23 suggesting that a depletion of glycogen stores and increased lipid oxidation are the characteristics of tissue catabolism in cirrhotic patients 24…”

Section: Discussionmentioning

confidence: 99%

Serum hepatocyte growth factor as an index of extensive catabolism of patients awaiting liver transplantation

Miki

Mayer

Buckels

et al. 1999

Gut

View full text Add to dashboard Cite

Background-Whole body catabolism as the result of intrahepatic metabolic derangement is common in liver transplant candidates. However, individual nutritional assessment parameters lack sensitivity and specificity in determining energy status of these patients. Recently, serum hepatocyte growth factor (HGF) has been shown to reflect the recovery of hepatic energy metabolism after liver transplantation. Aims-The relation between preoperative levels of serum HGF and metabolic variables was investigated to clarify the clinical value of measuring HGF in evaluations of the catabolism. Patients/Methods-Blood samples were obtained from 30 liver transplant recipients, and biopsy specimens were taken from each recipient's rectus muscle and the explanted liver. Preoperative serum concentration of HGF was determined. Whole body energy metabolism was assessed by measuring glycogen contents of biopsy specimens and plasma or serum levels of glucose, insulin, total ketone bodies, total carnitine, and amino acids. Results-Serum HGF concentration was elevated in 22 of 30 patients and correlated with the Child-Pugh score. It showed a negative association with muscle glycogen content, and a positive correlation with serum levels of glucose, total carnitine, and total ketone bodies. Patients with elevated serum HGF concentrations had higher preoperative plasma levels of aromatic amino acids and branched chain amino acids, associated with lower branched chain to aromatic amino acid ratios. Conclusions-The elevated serum concentration of HGF in liver transplant candidates reflected inhibition of peripheral glucose storage, enhanced lipid oxidation, and increased peripheral release of branched chain amino acids, and thus extensive energy catabolism. (Gut 1999;44:862-866)

show abstract

“…Jedoch ist das Ausmaß spontaner körperlicher Aktivität bei LC-Patienten erheblich geringer. Offensichtlich wird der erhöhte Energiebedarf im fortgeschrittenen Krankheitsstadium durch verringerte körperliche Aktivität als Abbild der schlechten körperlichen Verfassung ausgeglichen [76,77]. Bei zirrhotischen Patienten ohne Aszites sollte das tatsächliche Körpergewicht für die Berechnung der basalen Stoffwechselrate herangezogen und dabei Formeln wie z.…”

Section: Abstract !unclassified

S3-Leitlinie der Deutschen Gesellschaft für Ernährungsmedizin (DGEM) in Zusammenarbeit mit der GESKES, der AKE und der DGVS

Plauth

Schütz

Pirlich

et al. 2014

Aktuel Ernahrungsmed

View full text Add to dashboard Cite

Zusammenfassung Ziel: Mangelern?hrung wirkt sich negativ auf die Prognose aus und ist insbesondere bei Patienten mit chronischen Lebererkrankungen ein h?ufiger Befund. In der klinischen Praxis wird das Potenzial der Ern?hrungstherapie nicht v?llig ausgesch?pft. Mit dieser Leitlinie sollen umfassende aktuelle und evidenzbasierte Empfehlungen f?r die Ern?hrungstherapie von Patienten mit Lebererkrankungen gegeben werden. Methoden: Fr?here Leitlinien der Deutschen und der Europ?ischen Gesellschaft f?r Ern?hrungsmedizin (DGEM, ESPEN) zur enteralen und parenteralen Ern?hrung von Patienten mit Lebererkrankungen wurden entsprechend den Prinzipien der AWMF (Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften) und ?ZQ (?rztliche Zentralstelle f?r Qualit?tssicherung) aktualisiert und vollst?ndig ?berarbeitet und erweitert. Ergebnisse: Die vorliegende Leitlinie umfasst 80 im Konsentierungsverfahren ermittelte Empfehlungen zur Ern?hrungstherapie leberkranker Patienten im Hinblick auf pathophysiologische Grundlagen, Indikationsstellung und Durchf?hrung einer Ern?hrungstherapie sowie ihrer Ergebnisse. Empfehlungen werden f?r die Krankheitsbilder akutes Leberversagen (ALF), alkoholische Steatohepatitis (ASH), nicht alkoholische Steatohepatitis (NASH), Leberzirrhose (LC), Lebertransplantation und Operation sowie ern?hrungsbedingte Lebersch?digung (NALI) gegeben. Schlussfolgerung: Patienten mit chronischer Lebererkrankung leiden h?ufig an einer Mangelern?hrung; diese Patientengruppe profitiert daher von einer Ern?hrungstherapie. Die Datenlage ist bei ALF-Patienten wesentlich unsicherer, da nur wenige Untersuchungsergebnisse f?r diese schwere aber seltene Erkrankung vorliegen.

show abstract

Metabolic, endocrine, haemodynamic and pulmonary responses to different types of exercise in individuals with normal or reduced liver function

Cited by 18 publications

References 27 publications

Reduced Mitochondrial Adenosine Triphosphate Synthesis in Skeletal Muscle in Patients With Child–Pugh Class B and C Cirrhosis

Reduced Mitochondrial Adenosine Triphosphate Synthesis in Skeletal Muscle in Patients With Child–Pugh Class B and C Cirrhosis

Serum hepatocyte growth factor as an index of extensive catabolism of patients awaiting liver transplantation

S3-Leitlinie der Deutschen Gesellschaft für Ernährungsmedizin (DGEM) in Zusammenarbeit mit der GESKES, der AKE und der DGVS

Contact Info

Product

Resources

About