Measuring the Effect of a Study Meal on Portal Concentrations of Glucagon-Like Peptide 1 (GLP-1) in Non Diabetic and Diabetic Patients with Liver Cirrhosis: Transjugular Intrahepatic Portosystemic Stent Shunt (TIPSS) as a New Method for Metabolic Measurements

Autor: Ramadori G, U. Leonhardt, Scholz Kh, Dirk Raddatz, A. Buchwald, Rossbach C, W Nolte
Rok vydání: 2008
Předmět:
Adult
Liver Cirrhosis
Male
endocrine system
medicine.medical_specialty
Cirrhosis
Endocrinology
Diabetes and Metabolism
medicine.medical_treatment
Portal venous pressure
030209 endocrinology & metabolism
030204 cardiovascular system & hematology
Gastroenterology
Diabetes Complications
Eating
03 medical and health sciences
Liver disease
0302 clinical medicine
Endocrinology
Glucagon-Like Peptide 1
Liver Cirrhosis
Alcoholic
Internal medicine
Diabetes mellitus
Insulin Secretion
Internal Medicine
medicine
Humans
Insulin
Aged
business.industry
digestive
oral
and skin physiology
Stent
General Medicine
Middle Aged
medicine.disease
Glucagon-like peptide-1
3. Good health
Portal System
Female
Stents
Portasystemic Shunt
Transjugular Intrahepatic
business
hormones
hormone substitutes
and hormone antagonists
Liver Circulation
Hormone
Zdroj: Experimental and Clinical Endocrinology & Diabetes. 116:461-467
ISSN: 1439-3646
0947-7349
Popis: Background Diabetes in liver cirrhosis is associated with a blunted insulin response, which might be explained by an impaired release of the incretin hormone glucagon-like peptide 1 (GLP-1) into the portal circulation. Aims To investigate basal and stimulated portal venous and peripheral GLP-1 concentrations in non-diabetic (ND) and diabetic (D) patients with liver cirrhosis undergoing transjugular intrahepatic portosystemic stent shunt (TIPSS) implantation. Patients and methods After elective TIPSS portalvenous and peripheral probes were drawn from 10 ND and 10 D patients with stable liver disease during an oral metabolic test and plasma glucose, immunoreactive GLP-1, insulin and C-peptide were measured. Results The study meal led to a significant rise in portal GLP-1 levels in ND and D. Basal and stimulated portal GLP-1 concentrations were not significantly different between ND and D. Peripheral GLP-1 did not differ significantly from portal venous levels. Insulin response in ND was more pronounced in the portal blood than in the periphery and was absent in D. Conclusion TIPSS allows a direct evaluation of hormonal changes in the portal circulation during an oral metabolic tolerance test. A disturbed GLP-1 secretion does not play a role in blunting the insulin response observed in patients with hepatogenous diabetes.
Databáze: OpenAIRE
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