Background: Hypermetabolism, insulin resistance, and diabetes are common in patients with liver cirrhosis. Objective: We assessed whether diabetes and insulin resistance influence postabsorptive energy homeostasis in these patients and whether liver transplantation (LTx) and immunosuppressive drugs affect these relations. Design: Twenty-six patients with liver cirrhosis (16 with and 10 without diabetes) were studied with an insulin clamp and indirect calorimetry. Eleven of these subjects were studied 9 mo after LTx to longitudinally assess its effects. To cross-sectionally explore a longer follow-up period, we studied 65 patients 6, 14, and 32 mo after LTx. Seven patients with chronic uveitis (receiving immunosuppressive therapy) and 20 healthy subjects served as control subjects. Results: Diabetic and nondiabetic patients with cirrhosis had insulin resistance (SI(clamp); P < 0.03) and higher measured resting energy expenditure (REE) as a percentage of predicted REE than did healthy subjects (107.6 ± 1.8% compared with 97.4 ± 2.3%; P < 0.03), and these 2 alterations were associated (R2 = 0.119, P = 0.0002). The longitudinal study showed an improvement in the 2 variables after LTx, but full restoration was not achieved. The cross-sectional analysis confirmed this observation in patients studied 6 mo (n = 28) after LTx. In patients studied 14 (n = 21) and 32 mo (n = 16) after LTx, SI(clamp) and measured REE as a percentage of predicted REE were not significantly different from those in control subjects. Conclusions: In patients with liver cirrhosis, higher-than-normal postabsorptive REE was associated with insulin resistance regardless of diabetes. This abnormality persisted in patients studied 6-9 mo after LTx but improved simultaneously with the improvement in insulin sensitivity thereafter

Perseghin, G., Mazzaferro, V., Benedini, S., Pulvirenti, A., Coppa, J., Regalia, E., et al. (2002). Resting energy expenditure in diabetic and nondiabetic patients with liver cirrhosis: Relation with insulin sensitivity and effect of liver transplantation and immunosuppressive therapy. THE AMERICAN JOURNAL OF CLINICAL NUTRITION, 76(3), 541-548.

Resting energy expenditure in diabetic and nondiabetic patients with liver cirrhosis: Relation with insulin sensitivity and effect of liver transplantation and immunosuppressive therapy

PERSEGHIN, GIANLUCA
Primo
;
2002

Abstract

Background: Hypermetabolism, insulin resistance, and diabetes are common in patients with liver cirrhosis. Objective: We assessed whether diabetes and insulin resistance influence postabsorptive energy homeostasis in these patients and whether liver transplantation (LTx) and immunosuppressive drugs affect these relations. Design: Twenty-six patients with liver cirrhosis (16 with and 10 without diabetes) were studied with an insulin clamp and indirect calorimetry. Eleven of these subjects were studied 9 mo after LTx to longitudinally assess its effects. To cross-sectionally explore a longer follow-up period, we studied 65 patients 6, 14, and 32 mo after LTx. Seven patients with chronic uveitis (receiving immunosuppressive therapy) and 20 healthy subjects served as control subjects. Results: Diabetic and nondiabetic patients with cirrhosis had insulin resistance (SI(clamp); P < 0.03) and higher measured resting energy expenditure (REE) as a percentage of predicted REE than did healthy subjects (107.6 ± 1.8% compared with 97.4 ± 2.3%; P < 0.03), and these 2 alterations were associated (R2 = 0.119, P = 0.0002). The longitudinal study showed an improvement in the 2 variables after LTx, but full restoration was not achieved. The cross-sectional analysis confirmed this observation in patients studied 6 mo (n = 28) after LTx. In patients studied 14 (n = 21) and 32 mo (n = 16) after LTx, SI(clamp) and measured REE as a percentage of predicted REE were not significantly different from those in control subjects. Conclusions: In patients with liver cirrhosis, higher-than-normal postabsorptive REE was associated with insulin resistance regardless of diabetes. This abnormality persisted in patients studied 6-9 mo after LTx but improved simultaneously with the improvement in insulin sensitivity thereafter
Articolo in rivista - Articolo scientifico
Diabetes; Immunosuppressive therapy; Insulin resistance; Lipid oxidation; Liver cirrhosis; Liver transplantation; Resting energy expenditure; Medicine (miscellaneous); Food Science
English
541
548
8
Perseghin, G., Mazzaferro, V., Benedini, S., Pulvirenti, A., Coppa, J., Regalia, E., et al. (2002). Resting energy expenditure in diabetic and nondiabetic patients with liver cirrhosis: Relation with insulin sensitivity and effect of liver transplantation and immunosuppressive therapy. THE AMERICAN JOURNAL OF CLINICAL NUTRITION, 76(3), 541-548.
Perseghin, G; Mazzaferro, V; Benedini, S; Pulvirenti, A; Coppa, J; Regalia, E; Luzi, L
File in questo prodotto:
File Dimensione Formato  
AJCN-02.PDF

Solo gestori archivio

Dimensione 109.79 kB
Formato Adobe PDF
109.79 kB Adobe PDF   Visualizza/Apri   Richiedi una copia

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/10281/165502
Citazioni
  • Scopus 37
  • ???jsp.display-item.citation.isi??? 36
Social impact