Nonhepatic glucose production in humans

Alberto Battezzati, Andrea Caumo, Francesca Martino, Lucia Piceni Sereni, Jorgelina Coppa, Raffaele Romito, Mario Ammatuna, Enrico Regalia, Dwight E. Matthews, Vincenzo Mazzaferro, Livio Luzi

Research output: Contribution to journalArticle

50 Citations (Scopus)

Abstract

Extrahepatic glucose release was evaluated during the anhepatic phase of liver transplantation in 14 recipients for localized hepatocarcinoma with mild or absent cirrhosis, who received a bolus of [6,6-2H 2]glucose and L-[3-13C]alanine or L-[1,2 13C2]glutamine to measure glucose kinetics and to prove whether gluconeogenesis occurred from alanine and glutamine. Twelve were studied again 7 mo thereafter along with seven healthy subjects. At the beginning of the anhepatic phase, plasma glucose was increased and then declined by 15%/h. The right kidney released glucose, with an arteriovenous gradient of -3.7 mg/dl. Arterial and portal glucose concentrations were similar. The glucose clearance was 25% reduced, but glucose uptake was similar to that of the control groups. Glucose production was 9.5 ± 0.9 μmol·kg-1· min-1, 30% less than in controls. Glucose became enriched with 13C from alanine and especially glutamine, proving the extrahepatic gluconeogenesis. The gluconeogenic precursors alanine, glutamine, lactate, pyruvate, and glycerol, insulin, and the counterregulatory hormones epinephrine, cortisol, growth hormone, and glucagon were increased severalfold. Extrahepatic organs synthesize glucose at a rate similar to that of postabsorptive healthy subjects when hepatic production is absent, and gluconeogenic precursors and counterregulatory hormones are markedly increased. The kidney is the main, but possibly not the unique, source of extrahepatic glucose production.

Original languageEnglish
JournalAmerican Journal of Physiology - Endocrinology and Metabolism
Volume286
Issue number1 49-1
Publication statusPublished - Jan 2004

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Glucose
Glutamine
Alanine
Gluconeogenesis
Healthy Volunteers
Hormones
Kidney
Glucagon
Pyruvic Acid
Liver
Liver Transplantation
Epinephrine
Growth Hormone
Hydrocortisone
Lactic Acid
Fibrosis
Plasmas
Control Groups
Kinetics

Keywords

  • Amino acids
  • Intestines
  • Kidney

ASJC Scopus subject areas

  • Physiology
  • Endocrinology
  • Biochemistry

Cite this

Battezzati, A., Caumo, A., Martino, F., Sereni, L. P., Coppa, J., Romito, R., ... Luzi, L. (2004). Nonhepatic glucose production in humans. American Journal of Physiology - Endocrinology and Metabolism, 286(1 49-1).

Nonhepatic glucose production in humans. / Battezzati, Alberto; Caumo, Andrea; Martino, Francesca; Sereni, Lucia Piceni; Coppa, Jorgelina; Romito, Raffaele; Ammatuna, Mario; Regalia, Enrico; Matthews, Dwight E.; Mazzaferro, Vincenzo; Luzi, Livio.

In: American Journal of Physiology - Endocrinology and Metabolism, Vol. 286, No. 1 49-1, 01.2004.

Research output: Contribution to journalArticle

Battezzati, A, Caumo, A, Martino, F, Sereni, LP, Coppa, J, Romito, R, Ammatuna, M, Regalia, E, Matthews, DE, Mazzaferro, V & Luzi, L 2004, 'Nonhepatic glucose production in humans', American Journal of Physiology - Endocrinology and Metabolism, vol. 286, no. 1 49-1.
Battezzati A, Caumo A, Martino F, Sereni LP, Coppa J, Romito R et al. Nonhepatic glucose production in humans. American Journal of Physiology - Endocrinology and Metabolism. 2004 Jan;286(1 49-1).
Battezzati, Alberto ; Caumo, Andrea ; Martino, Francesca ; Sereni, Lucia Piceni ; Coppa, Jorgelina ; Romito, Raffaele ; Ammatuna, Mario ; Regalia, Enrico ; Matthews, Dwight E. ; Mazzaferro, Vincenzo ; Luzi, Livio. / Nonhepatic glucose production in humans. In: American Journal of Physiology - Endocrinology and Metabolism. 2004 ; Vol. 286, No. 1 49-1.
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