Glucose turnover at whole-body and skeletal muscle level in response to parenteral nutrition in male patients with alcoholic liver cirrhosis
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Glucose turnover at whole-body and skeletal muscle level in response to parenteral nutrition in male patients with alcoholic liver cirrhosis. / Trinh, Beckey; Rasmussen Rinnov, Anders; Winning Iepsen, Ulrik; Winding Munch, Gregers; Munch Winding, Kamilla; Lauridsen, Carsten; Gluud, Lise Lotte; van Hall, Gerrit; Ellingsgaard, Helga.
I: Clinical Nutrition ESPEN, Bind 60, 2024, s. 240-246.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - Glucose turnover at whole-body and skeletal muscle level in response to parenteral nutrition in male patients with alcoholic liver cirrhosis
AU - Trinh, Beckey
AU - Rasmussen Rinnov, Anders
AU - Winning Iepsen, Ulrik
AU - Winding Munch, Gregers
AU - Munch Winding, Kamilla
AU - Lauridsen, Carsten
AU - Gluud, Lise Lotte
AU - van Hall, Gerrit
AU - Ellingsgaard, Helga
PY - 2024
Y1 - 2024
N2 - Background & aims: Cirrhosis is associated with insulin resistance and impaired glucose tolerance, which may be caused by impairments at different tissue levels (liver, skeletal muscle, and/or beta cell). Methods: Here, glucose kinetics at whole-body and skeletal muscle level in patients with cirrhosis (Child-Pugh A and B) were studied during parenteral nutrition using the isotope dilution technique and arteriovenous balance approach across the leg. As opposed to the euglycemic hyperinsulinemic clamp or glucose tolerance tests applied in previous studies, this approach provides a nutrient composition more similar to a normal meal while circumventing any possible portal-systemic shunting, impaired hepatic uptake and incretin effect. Results: We confirmed the presence of hepatic and peripheral insulin resistance in our patient population. Endogenous glucose production was less suppressed in response to parenteral nutrition. However, glucose uptake in skeletal muscle was increased. Conclusion: Our results suggests that in our study participants with cirrhosis, the hepatic and peripheral insulin resistance is compensated for by increased insulin secretion and thus, increased glucose uptake in muscle. Hereby, glucose homeostasis is maintained.
AB - Background & aims: Cirrhosis is associated with insulin resistance and impaired glucose tolerance, which may be caused by impairments at different tissue levels (liver, skeletal muscle, and/or beta cell). Methods: Here, glucose kinetics at whole-body and skeletal muscle level in patients with cirrhosis (Child-Pugh A and B) were studied during parenteral nutrition using the isotope dilution technique and arteriovenous balance approach across the leg. As opposed to the euglycemic hyperinsulinemic clamp or glucose tolerance tests applied in previous studies, this approach provides a nutrient composition more similar to a normal meal while circumventing any possible portal-systemic shunting, impaired hepatic uptake and incretin effect. Results: We confirmed the presence of hepatic and peripheral insulin resistance in our patient population. Endogenous glucose production was less suppressed in response to parenteral nutrition. However, glucose uptake in skeletal muscle was increased. Conclusion: Our results suggests that in our study participants with cirrhosis, the hepatic and peripheral insulin resistance is compensated for by increased insulin secretion and thus, increased glucose uptake in muscle. Hereby, glucose homeostasis is maintained.
KW - Cirrhosis
KW - Glucose
KW - Human
KW - Skeletal muscle
KW - Stable isotopes
U2 - 10.1016/j.clnesp.2024.02.013
DO - 10.1016/j.clnesp.2024.02.013
M3 - Journal article
C2 - 38479917
AN - SCOPUS:85186242972
VL - 60
SP - 240
EP - 246
JO - Clinical Nutrition ESPEN
JF - Clinical Nutrition ESPEN
SN - 2405-4577
ER -
ID: 385137778