Altered postprandial glucose, insulin, leptin, and ghrelin in liver cirrhosis: correlations with energy intake and resting energy expenditure  

Oleh:

Kalaitzakis, Evangelos ; Bosaeus, Ingvar ; Ohman, Lena ; Björnsson, Einar

Jenis: Article from Journal - ilmiah internasional
Dalam koleksi: The American Journal of Clinical Nutrition vol. 85 no. 03 (Mar. 2007), page 808.
Topik: Glucose • insulin • leptin • ghrelin • insulin resistance • energy intake • resting energy expenditure • liver cirrhosis • malnutrition

Ketersediaan

Perpustakaan FK Nomor Panggil: A07.K.2007.01 Non-tandon: 1 (dapat dipinjam: 0) Tandon: tidak ada

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Isi artikel

1 From the Department of Internal Medicine, Faculty of Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden (EK, IB, and EB), and the Department of Clinical Immunology, Faculty of Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden (LÖ) Background: Liver cirrhosis is associated with reduced energy intake and increased resting energy expenditure. Objective:We aimed to investigate the possible role of glucose, insulin, leptin, and ghrelin in the pathogenesis of these alterations. Design:Nutritional status, energy intake, resting energy expenditure, and fasting glucose, insulin, and leptin were assessed in 31 patients with cirrhosis. Postprandial glucose, insulin, C-peptide, leptin, and ghrelin responses were studied in a subgroup of patients after a standard meal. Ten healthy subjects served as controls. Results:Patients with cirrhosis had a lower energy intake (P < 0.05), higher resting energy expenditure (P < 0.05), higher fasting leptin (P < 0.05), and higher insulin resistance (P < 0.001) than did the healthy control subjects. In the patients with cirrhosis, fasting leptin was negatively correlated with resting energy expenditure (r = –0.38, P < 0.05) but not with energy intake. In control subjects, leptin was negatively correlated with energy intake (r = –0.72, P < 0.05) but not with resting energy expenditure. The patients with cirrhosis had higher postprandial glucose (P < 0.001) and lower ghrelin (P < 0.05) concentrations at 4 h postprandially than did the control subjects. The increase in ghrelin from its minimal postmeal value to 4 h postmeal was negatively correlated (r = –0.66, P = 0.014) with weight loss in the patients with cirrhosis. Energy intake was negatively correlated (r = –0.42, P < 0.01) with the postprandial increase in glucose. Conclusions:In cirrhosis, altered postprandial glucose and ghrelin are associated with reduced energy intake and weight loss, respectively, and the effects of leptin on energy intake and expenditure seem to be altered. Insulin resistance might be involved in these altered postprandial responses.

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