Carbohydrate intolerance associated with reduced hepatic glucose phosphorylating and releasing enzyme activities and peripheral insulin resistance in alcoholics with liver cirrhosis

• Published in: Journal of hepatology Vol. 1; no. 3; pp. 277 - 290
• Main Authors: Sotaniemi, Eero A., Keinänen, Kari, Lahtela, Jorma T., Arranto, Arno J., Kairaluoma, Matti
• Format: Journal Article
• Language: English
• Published: Oxford Elsevier B.V 1985; Elsevier
• Subjects: Adult; Aged; Alcoholism and acute alcohol poisoning; Antipyrine - metabolism; Biological and medical sciences; Blood Glucose - metabolism; Collagen - metabolism; Glucokinase - analysis; Glucose - metabolism; Glucose-6-Phosphatase - analysis; Hexokinase - analysis; Humans; Insulin Resistance; Liver - enzymology; Liver Cirrhosis, Alcoholic - metabolism; Male; Medical sciences; Middle Aged; Phosphorylation; Toxicology; Endocrinopathy; Human; Alcoholism; Liver; Metabolic diseases; Hepatobiliary disease; Insulin; Cirrhosis; Protein hormone; Target tissue resistance; Digestive diseases; Carbohydrate; Poisoning; Hormonal investigation; Impaired glucose tolerance
• ISSN: 0168-8278; 1600-0641
• DOI: 10.1016/S0168-8278(85)80055-6

Carbohydrate intolerance was investigated in 8 alcoholics with liver cirrhosis and in controls. Indices of carbohydrate metabolism, glucose and insulin levels after glucose loading, were compared with glucose phosphorylating (glucokinase, hexokinase) and releasing (glucose-6-phosphatase) enzymes. Comparison was also made with pericellular collagen in liver biopsies and with insulin sensitivity assessed by the euglycemic clamp technique and with conventional liver function tests including oral antipyrine test. Glucokinase activity was low or absent, hexokinase activity increased and the GK/HK ratio reduced. Glucose-6-phosphatase activity was lowered and insulin sensitivity decreased. Pericellular collagen was increased ( P < 0.001) and related to the fasting glucose ( r 0.593) and insulin levels ( r 0.526). Blood glucose was related to antipyrine metabolism ( r −0.727) but not to the other liver tests. Glucose intolerance in cirrhosis seems to be associated with reduced glucose phosphorylating and liberating enzyme activities. Hyperinsulinaemia, developing secondarily, may then lead to insulin resistance.