Glucose Turnover in Compensated Hepatic Cirrhosis

Summary

Glucose turnover and recycling from glucose derived 3-carbon intermediates were examined in overnight fasted patients with compensated hepatic cirrhosis and in age- and weight-matched normal control subjects. Fasting blood concentrations of glucose, lactate and glycerol were similar in both groups but blood pyruvate (60 ± 10 vs 80 ± 10 μmol/l, P < 0.05), blood alanine (0.23 ± 0.02 vs 0.34 ± 0.02 mmol/l, P < 0.01) were decreased and serum insulin increased (19 [13-24] v 7 [4-11] mU/l, P < 0.01) in cirrhotic subjects. Absolute glucose turnover, assessed by analysis of decay of [³H]-3-glucose specific activity was decreased in cirrhotic patients (8.1 ± 0.6 v 12.1 ± 0.7 mol/kg^-1 min^-1). Glucose “recycling”, assessed by the difference between absolute glucose turnover and that given by [¹⁴C]-1-glucose data, was normal in cirrhotic patients suggesting that Cori cycle (glucose-lactate-glucose) activity was normal. These data support previous findings of decreased peripheral glucose utilisation and insulin resistance in cirrhotic patients.

Key-Words

Glucose Turnover - Glucose Recycling - Hepatic Cirrhosis - Insulin Resistance