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Query: UMLS:C0023890 (cirrhosis)
 42,195 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Derangements in glucose, amino acid and protein metabolism in patients with liver cirrhosis were examined with special reference to plasma levels of human growth hormone (HGH). Changes in blood glucose, IRI (immunoreactive insulin), HGH, FFA (free fatty acid) and plasma free amino acid levels were determined in controls and patients following either oral glucose load, protein feeding or intravenous arginine infusion. 1) In patients with liver cirrhosis, incidence of glucose intolerance after glucose tolerance test (GTT) was high and IRI levels were elevated in the fasting state as well as after glucose, protein or arginine loads. 2) Fasting levels of blood HGH were significantly higher in liver cirrhosis than in controls. GTT revealed that blood HGH levels decreased slightly during the rising phase of blood glucose, and conversely, increased during the falling phase of glucose (180 minutes after the glucose load) both in controls and in patients. In cirrhotic patients, marked increases in HGH levels were observed both 120 minutes after the protein load and 60 minutes after the arginine infusion. 3) Fasting levels of serum FFA were significantly higher in liver cirrhosis than in controls. Both controls and patients, however, showed a similar pattern of change in FFA levels following GTT or protein ingestion, i.e. a minimum value 120 minutes after the load and a gradual increase thereafter. 4) Fasting levels of plasma free amino acids were significantly higher in cirrhotic patients than in controls. After the glucose load, however, slight decrease was noted in some amino acid levels. All the amino acid levels examined were elevated following protein ingestion, particularly in cirrhotic patients. 5) A positive correlation was demonstrated in cirrhotic patients between total plasma free amino acids and maximal HGH responses following protein ingestion. Similar significant correlations were observed between the maximal HGH response and the plasma level of several amino acids such as His., Ser., Gly., Thr., Ala., and Ileu., respectively. 6) In cirrhotic patients, negative correlations were demonstrated between fasting levels of serum albumin and total plasma free amino acids or maximal HGH responses, respectively, after the protein ingestion. From these results it was inferred that derangements in the metabolism of protein and amino acids in cirrhotic patients may result in an increase in plasma free amino acid level which in turn stimulates HGH secretion. It was surmised that the HGH levels so elevated in the patients may cause FFA mobilization which in effect results in the glucose intolerance.
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PMID:[Studies on glucose, amino acid and protein metabolism in patients with liver cirrhosis in relation to plasma levels of human growth hormone (author's transl)]. 81 50

The cholesterol-lowering effect of portacaval anastomosis in homozygous familial hypercholesterolemia suggested a study of lipid metabolism in cirrhotic patients after portasystemic anastomoses. Fasting serum cholesterol, triglycerides, insulin, and glucagon levels were obtained in 20 patients with alcoholic cirrhosis and portacaval anastomosis, and in 21 nonshunted subjects with cirrhosis. After 100 g of glucose, given orally, insulin and glucagon levels were measured. In the shunted patients serum cholesterol was higher than in the nonshunted subjects, 240 +/- 15 mg per 100 ml (mean +/- 1 SEM) versus 180 +/- 13 mg per 100 ml, P less than 0.01. Triglycerides were normal in both groups. Fasting insulin was elevated to a greater extent in the shunted patients with cirrhosis (36 +/- 5 muU per ml) than in the nonshunted patients (22 +/- 4 muU per ml), P less than 0.05. Two hours after glucose, insulin levels were also elevated to a greater extent in the shunted subjects (304 +/- 50 muU per ml) than in the nonshunted subjects (167 +/- 29 muU per ml), P less than 0.03. Fasting glucagon (corrected for interference factor) was elevated to a greater extent in the shunted subjects (204 +/- 35 pg per ml) than in the nonshunted subjects (80 +/- 19 pg per ml), P less than 0.01. The explanation for serum cholesterol elevation after surgical shunting in cirrhotics is unknown. Two possible hypotheses--the differential action of insulin and glucagon on cholesterol metabolism and the effects of shunting on the cirrhotic liver--are discussed.
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PMID:Serum lipids, insulin, and glucagon after portacaval shunt in cirrhosis. 83 May 79

In a survey the trend of the biochemical investigations in hepatology is analysed. Together with the histologic diagnosis the function of the liver parenchyma must be determined, in which cases tolerance tests which do not only determine the function of the liver parenchyma, but also the changed functions of other organs are of importance. On the basis of own findings is shown that the ammonia metabolism in patients with hepatic encephalopathy is also disturbed in musculature. In the serum of patients with decompensated liver cirrhosis a factor could be isolated which apart from the inhibition of the utilisation of glucose has also another metabolic effect. In future we might expect an intensified search for such active metabolites. Investigations concerning the salicylaemia in patients with liver cirrhosis and experimental findings about changes of the O-demethylase activity in the fatty degeneration of the liver show the great significance of the pharmacokinetic analyses in the clinical hepatology.
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PMID:[Perspectives of clinical biochemistry in hepatology]. 85 Oct 12

40 patients with infectious hepatitis, 25 with chronic aggressive hepatitis, 25 with compensated liver cirrhosis, and 10 with decompensated liver cirrhosis were submitted to examination. The following abnormalities depending upon the stage and severity of hepatic diseases were found: a) disturbances of total lipids, cholesterol, phospholipids, beta-lipoproteids, glycerin, glycerides and neutral fats concentrations; b) marked disorders of glucose tolerance as indicated by the difference between plasma and erythrocyte glucose levels increasing in proportion to the degree of liver damage; c) a fall in plasma and erythrocyte magnesium reflecting the degree of hepatic parenchyma damage; d) a decrease of the albumin/gamma-globulin ratio in proportion to the degree of the impairment of hepatic cells. The presented fat, carbohydrate, magnesium and protein balance indices yield better criterions for the differential diagnostics of hepatic diseases than the routine investigations, and they also make possible objective prognosis.
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PMID:Disturbances of fat, carbohydrate, magnesium and protein balance in liver diseases. 88 63

Disorders of the central nervous system were found in 150 rats five monthds after en-to-side-porta-caval anastomosis consisting of vacuolisated cytoplasma of gangliacells and reactions of the glia comparable with the Alzheimer-glia-type II. Since these disorders are consistent with those in patients with liver cirrhosis but induced in these experiments by a porta-caval anastomosis alone, they are proposedly independent from liver disease itself. It is discussed whether disorders in glucose homeostai may be of pathogenetic relevance. Atrophy of tests, found in the late postoperative phase and erosions or ulcers of gastric mucosa as well as nephrolithiasis with hydronephrosis as consequence, the latter occuring independently from the time after operations, are proposedly due to the porta-caval anastomosis, too.
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PMID:[Morphological investigations of extrahepatic disorders after porta-caval end-to-side-anastomosis in rats (author's transl)]. 89 4

Peculiarities of clinical picture of diabetes mellitus in its combination with chronic hepatitis and cirrhosis of the liver were studied in 60 patients. Diabetes mellitus developed mostly against the background of chronic affection of the liver, preceding it. Glucose tolerance disturbances according to the type of latent and manifest diabetes were revealed in 28% of 132 patients with chronic hepatitis and cirrhosis of the liver. Histological study of the pancreas in 63 patients who died of cirrhosis of the liver demonstrated marked fibrosis of hepatic parenchyma without any noticeable changes in the pancreatic islets. The blood insulin and growth hormone levels were significantly greater in 132 patients examined than in healthy persons. The mentioned changes in the glycemia level, of the insulin and growth hormone level after glucose administration were more pronounced in cirrhosis of the liver than in chronic hepatitis, and in late stages of portal cirrhosis than at its early stages. The leading role played by insulin sensitivity reduction of the peripheral tissues in the pathogenesis of carbohydrate metabolism in cases with chronic diseases of the liver is supposed.
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PMID:[Clinical picture and pathogenesis of diabetes mellitus in chronic hepatitis and cirrhosis of the liver]. 90 62

In 21 patients with liver cirrhosis, 35 normal subjects, 8 patients with chemical and 11 with manifest diabetes 0.5 g glucose/kg together with 14C-glucose were injected intravenously. 71% of the cirrhotics showed an impaired glucose tolerance. IRI response was exaggerated. The insulinogenic index was elevated in patients with liver cirrhosis and normal glucose tolerance and normal or subnormal in those with carbohydrate intolerance, as well as in diabetics. Decrease of the specific activity of glucose, expressing supply of non-labelled glucose to the body pool, was much more rapid in patients with carbohydrate intolerance, either hepatogenic or not, when compared at equal glucose concentrations. Moreover all groups with deteriorated glucose tolerance exhaled less 14CO2. Consequently, diabetes in chronic liver disease displays the same abnormalities as diabetes in obesity with respect to liver glucose supply and glucose oxidation. In both conditions diminished glucose assimilation is usually the result of reduced removal and increased supply. Therefore it is concluded that impaired hepatic uptake of glucose cannot be implicated as a single cause of hepatogenic diabetes.
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PMID:[Insulin resistance and blood glucose replacement rates in liver cirrhosis. Studies with 14C-glucose (author's transl)]. 90 3

The total free fatty acids, blood glucose, and individual free fatty acids were studied in 8 patients with viral hepatitis and 13 with cirrhosis. The results were compared with those obtained in 9 normal control subjects. Free fatty acids were significantly elevated in liver patients as compared with normal controls. A fall in free fatty acids following ingestion of amino acids and dextrose was noted in normal subjects as well as liver patients. Glucose tolerance test, when done on patients with liver disease, was abnormal in most cases. Highly significant differences were found in the composition of individual free fatty acids in liver patients as compared with normal subjects. Arachidonic and linoleic acids were decreased, while monounsaturated and saturated fatty acids were increased in patients with viral hepatitis and cirrhosis. No significant changes were noted in the percent composition of individual free fatty acids following ingestion of amino acids and dextrose.
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PMID:Individual free fatty acids in patients with liver disease. 92 Jun 97

Blood sugar, insulin and GH values were examined in two groups of cirrhosis of the liver patients, with and without ascites, after the administration of 100 g glucose per os. No significant differences between the two groups were observed. Insulin values were higher than those in the controls, with a pattern similar to that noted in subjects with chemical diabetes. GH values were higher than in normal subjects and secretion was not suppressed.
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PMID:[Plasma insulin and GH during oral glucose load in liver cirrhosis]. 95 Oct 48

The changes of blood glucose, serum insulin, serum free fatty acid and its fatty acid composition following oral glucose load were observed in twenty-nine cirrhotic patients. The insulin secretory response was significantly lower in the cirrhotic patients with overt diabetes than in those without overt diabetes. There were no definite relation between serum free fatty acid level or its composition and glucose intolerance. These results suggest that the diabetic state in most of the cirrhotic patients with overt diabetes is due to essential diabetes and that serum free fatty acid livel and its composition are not important factors contributory to the glucose intolerance in liver cirrhosis.
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PMID:Clinical investigation on abnormal glucose tolerance in liver cirrhosis. 97 84


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