Impaired splanchnic and peripheral glucose uptake in liver cirrhosis

Background/Aim: Patients with liver cirrhosis are insulin-resistant and fre quently glucose-intolerant. Although peripheral glucose uptake has been sho wn to be impaired in liver cirrhosis, little is known about the significanc e of splanchnic (hepatic) glucose uptake after oral glucose load. Methods/Results: We performed an oral glucose tolerance test and euglycemic hyperinsulinemic clamp with oral glucose load for eight patients with live r cirrhosis and eight patients with chronic active hepatitis, The patients with liver cirrhosis had higher plasma glucose levels 2 h after glucose loa d than those with chronic active hepatitis (228 +/- 22 mg/dl vs 102 +/- 9 m g/dl, p<0.01). Using the euglycemic hyperinsulinemic clamp with oral glucos e load, we simultaneously measured peripheral and splanchnic glucose uptake . Peripheral glucose uptake in liver cirrhosis was 6.1+0.7 mg.kg(-1).min(-1 ) which was lower than that in healthy volunteers (10.5 +/- 0.9 mg.kg(-1).m in(-1), p<0.05) and in chronic active hepatitis (8.4 +/- 0.3 mg.kg(-1).min( -1), p<0.05), Furthermore, splanchnic glucose uptake in liver cirrhosis was much lower (20.1 +/- 3.4%) than in healthy volunteers (36.0 +/- 4.0%, p<0. 05) and in chronic active hepatitis (37.2 +/- 3.11%, p<0.05). Conclusion: These results suggest that glucose intolerance in patients with liver cirrhosis is caused by a defect of the glucose uptake of both splanc hnic and peripheral tissues.