Glucose disposal, β-cell secretion, and hepatic insulin extraction in cirrhosis: A minimal model assessment

摘要: Abstract Factors controlling glucose metabolism after IV load were studied in nine patients with compensated cirrhosis and six age-matched controls. The time courses of glucose, insulin, C peptide analyzed by means the minimal model technique. In cirrhosis, insulin sensitivity was reduced approximately 70% glucose-dependent uptake (glucose effectiveness) 45%. Decreased effectiveness explained 65% variance disappearance correlated ratio urinary creatinine to height, an independent measure muscle mass ( r = 0.839). β-cell responsiveness measured on C-peptide kinetics, variable increased average 170% 107% (first-phase second-phase, respectively). total amount secreted β-cells course study nearly doubled, whereas basal secretion rate normal range. hepatic extraction did not differ between groups, 58% controls 56% cirrhosis. It 30% a single patient who had severe hepatocellular failure large spontaneous portosystemic shunting. We conclude that alterations include decreased sensitivity, effectiveness, pancreatic leading hyperinsulinemia. is only very advanced stages disease, possibly because reserve capacity parenchyma.