Mechanisms of hyperinsulinaemia in Child's disease grade B liver cirrhosis investigated in free living conditions

A. V. Greco, G. Mingrone, A. Mari, E. Capristo, M. Manco, G. Gasbarrini

Research output: Contribution to journalArticle

Abstract

Aims: Human liver cirrhosis is commonly associated with increased fasting and glucose induced insulin concentrations. However, whether the hyperinsulinaemia is a consequence of increased pancreatic insulin secretion, decreased hepatic insulin removal, or impaired feedback regulation of insulin secretion is still doubtful. To investigate these issues, insulin secretion - during 24 hours of standardised living conditions - insulin sensitivity, and hepatic insulin extraction were assessed in cirrhotic patients compared with matched healthy subjects. Patients: Nine Child's disease grade B cirrhotic patients and seven healthy volunteers, participated in the study. The subjects were studied on two separate days, one for the assessment of insulin secretion during a standardised 24 hour life period (calorimetric chamber), and one for the determination of insulin sensitivity. Methods: Insulin secretion rates were reconstructed from plasma C peptide concentrations by deconvolution, and indices of β cell function were derived using a mathematical model describing the functional dependence of insulin secretion on plasma glucose concentrations. Insulin sensitivity was determined using the euglycaemic hyperinsulinaemic clamp technique. Results: Cirrhotic patients showed a marked hypersecretory response, both in absolute terms (mean (SEM) 295 (53) versus 138 (11) nmol/m2, p2, p2, p

Original languageEnglish
Pages (from-to)870-875
Number of pages6
JournalGut
Volume51
Issue number6
DOIs
Publication statusPublished - Dec 2002

ASJC Scopus subject areas

  • Gastroenterology

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