Serum bile acids and leptin interact with glucose metabolism in patients with liver cirrhosis.

Clin Nutr 2013 Feb 6;32(1):122-9. Epub 2012 Jul 6.

Charité - Universitätsmedizin Berlin, Department of Gastroenterology, Infectiology and Rheumatology (incl. section on Clinical Nutrition), Charitéplatz 1, Berlin 10117, Germany.

Background & Aims: We investigated possible involvements of bile acids (BA) and leptin in hepatogenous insulin resistance being present in up to 90% of cirrhotic patients.

Methods: Blood was analysed in 10 cirrhotic patients (8m/2f, 48 ± 10.4 yrs) and 10 controls (8m/2f, 43 ± 9.3 yrs) after oral nutrition and during 1 h of parenteral feeding. In patients, leptin was additionally analysed from mesenteric and arterial blood.

Results: Cirrhosis patients showed typical signs of hepatogenous insulin resistance (hyperinsulinaemia, normoglycaemia, hyperglucagonaemia). Both fasting BA (r = .714, p = 0.047) and fasting leptin (r = .867, p = 0.001) correlated to HOMA and predicted insulin response after oral feeding (R²adj = .783, p = 0.002). But during parenteral nutrition only leptin predicted insulin response (p = 0.005). The prandial glucose response was negatively correlated to the BA increase after oral nutrition (r = -.733, p = 0.028) and to the change in leptin during parenteral nutrition (r = -.738, p = 0.037) pointing towards a nutritional route-dependent positive impact on glucose tolerance of both substances. Prandial glucagon response was correlated to BA under both feeding conditions (p < 0.05). We found no relevant intestinal release of leptin during fasting or feeding conditions.

Conclusion: Our results suggest a substantial involvement of BA and leptin by improving postprandial glucose tolerance related to liver cirrhosis.

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.clnu.2012.06.006DOI Listing
February 2013
76 Reads

Publication Analysis

Top Keywords

predicted insulin
8
glucose tolerance
8
liver cirrhosis
8
insulin resistance
8
parenteral nutrition
8
hepatogenous insulin
8
insulin response
8
oral nutrition
8
acids leptin
8
bile acids
8
leptin
8
r²adj 783
4
0002 parenteral
4
783 0002
4
leptin predicted
4
response negatively
4
negatively correlated
4
correlated increase
4
glucose response
4
prandial glucose
4

Similar Publications