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Serum Glucose, Insulin, and Growth Hormone in Chronic Hepatic Cirrhosis

Serum Glucose, Insulin, and Growth Hormone in Chronic Hepatic Cirrhosis Abstract Plasma glucose, radioimmunoassayable insulin, and growth hormone (HGH) concentrations were measured during oral glucose tolerance tests, (GTT) in 22 patients with chronic hepatic cirrhosis and in 15 normal subjects. Of the cirrhotics, 50% had normal results and 50% showed impaired glucose tolerance. Cirrhotic patients with normal results showed hyperinsulinism. Abnormal results for GTT were associated with hypoinsulinism compared with normal subjects. Fasting levels of HGH were higher than in normal subjects. During GTT, HGH levels in 18 cirrhotics were either not suppressed or showed paradoxical rise but normal subjects had complete suppression. Patients with hepatic cirrhosis and abnormal GTT results had higher HGH levels at 60, 90, and 120 minutes compared with patients with normal GTT results. High HGH levels may be responsible for the high incidence of abnormal glucose tolerance in hepatic cirrhosis and hyperinsulinism preceding hypoinsulinism. References 1. Naunyn, D.: Der Diabetes mellitus , ed 2, Vienna: Holder, 1906, pp 128-139. 2. Bloodworth, J.M.B., Jr.: Diabetes Mellitus and Cirrhosis of the Liver , Arch Intern Med 108:695-701 ( (Nov) ) 1961.Crossref 3. Samaan, N.; Stillman, D.; and Fraser, R.: Abnormalities of Serum Insulin-Like Activity in Liver-Disease , Lancet 2:1287-1290 ( (Dec 22) ) 1962.Crossref 4. Debry, G., and Charles, J.: Etude des perturbations du métabolisme des glucides chez les sujets atteints de cirrhose hépatique , Diabete 13:151-168 ( (April-May) ) 1965. 5. Megyesi, C.; Samols, E.; and Marks, V.: Glucose Tolerance and Diabetes in Chronic Liver Disease , Lancet 2:1051-1055 ( (Nov 18) ) 1967.Crossref 6. Danowski, T.S., et al: Significance of Blood Sugar and Serum Electrolyte Changes in Cirrhosis Following Glucose, Insulin, Glucagon, or Epinephrine , Yale J Biol Med 29:361-375 ( (Dec) ) 1957. 7. Creutzfeldt, W.; Willie, D.; and Kaup, H.: Intravenous Injections of Glucose, Insulin, and Tolbutamide in Healthy Persons, Diabetics, Cirrhotics, and Patients With Insuloma: Together With a Contribution on the Diagnostic Value of Tolbutamide Tests , Deutsch Med Wschr 87: 2189-2195 ( (Oct) ) 1962.Crossref 8. Samaan, N., and Stone, D.: Growth Hormone and Serum Insulin in Response to a Glucose Load in Chronic Hepatic Cirrhosis, abstracted , J Lab Clin Med 70: 986 ( (Dec) ) 1967. 9. Morgan, C.R., and Lazarow, A.: Immunoassay of Insulin: Two Antibody System , Diabetes 12:115-126 ( (March-April) ) 1963. 10. Hunter, W.M., and Greenwood, F.C.: Radioimmunoelectrophoretic Assay for Human Growth Hormone , Biochem J 91: 43-56 ( (April) ) 1964. 11. Samaan, N.A., et al: Serum Placental Lactogen Levels During Pregnancy and in Trophoblastic Disease , J Clin Endocr 26:1303-1308 ( (Dec) ) 1966.Crossref 12. Schalch, D.S., and Parker, M.L.: A Sensitive Double Antibody Immunoassay for Human Growth Hormone in Plasma , Nature 203:1141-1142 ( (Sept) ) 1964.Crossref 13. Butterfield, W.J.H.: Summary of Results of the Bedford Diabetes Survey , Proc Roy Soc Med 57:196-202 ( (March) ) 1964. 14. Sonksen, P.H.. et al: Plasma Insulin: A Correlation Between Bioassay and Immunoassay , Brit Med J 2:209-210 ( (July 14) ) 1965.Crossref 15. Fraser, R., et al: The Augmented Insulin Tolerance Test for Detecting Insulin Resistance , J Endocr 25:299-307 ( (Dec) )) 1962.Crossref 16. Burt, R.L.: Peripheral Utilization of Glucose in Pregnancy; Insulin Tolerance , Obstet Gynec 7:658-664 ( (June) ) 1956. 17. Perley, M., and Kipnis, D.M.: Effect of Glucocorticoids on Plasma Insulin , New Eng J Med 274:1237-1241 ( (June 17) ) 1966.Crossref 18. Luft, R.; Cerasi, E.; and Hamberger, C.A.: Pathogenesis of Diabetes in Acromegaly , Acta Endocr 56:593-607 ( (Dec) ) 1967. 19. Kalkhoff, et al: Diabetogenic Factors Associated With Pregnancy , Trans Assoc Amer Phys 77:270-280, 1964. 20. Fajans, S.S., and Conn, J.W.: The Early Recognition of Diabetes Mellitus , Ann NY Acad Sci 82:208-218 ( (Sept) ) 1959.Crossref 21. Daughaday, W.H., and Kipnis, D.M.: The Growth-Promoting and Anti-insulin Actions of Somatotropin , Recent Progr Hormone Res 22:49-99, 1966. 22. Beck, P.; Parker, M.L.; and Daughaday, W.H.: Paradoxical Hypersecretion of Growth Hormone in Response to Glucose , J Clin Endocr 26:463-469 ( (April) ) 1966.Crossref 23. Josimovich, J.B., and McLaren, J.A.: Presence in Human Placenta and Term Serum of Highly Lactogenic Substance Immunologically Related to Pituitary Growth Hormone , Endocrinology 71:209-220 ( (Aug) ) 1962.Crossref 24. Samaan, N.; Yen, S.C.C.; and Pearson, O.H.: Serum Placental Lactogen Levels During Pregnancy and in Trophoblastic Disease , J Clin Endocr 26:1303-1308 ( (Dec) ) 1966.Crossref 25. Samaan, N., et al: Metabolic Effects of Placental Lactogen (HPL) in Man , J Clin Endocr 28:485-491 ( (April) ) 1968.Crossref 26. Zumoff, B., et al: Cortisol Metabolism in Cirrhosis , J Clin Invest 46:1735-1743 ( (Nov) ) 1967.Crossref 27. Peterson, R.E.: Adrenocortical Steroid Metabolism and Cortical Function in Liver Disease , J Clin Invest 39:320-331 ( (Feb) ) 1960.Crossref 28. Roth, J., et al: Secretion of Human Growth Hormone: Physiologic and Experimental Modifications , Metabolism 12: 577-579 ( (July) ) 1963. 29. Hunter, W.M.; Clarke, B.F.; and Duncan, L.J.P.: Plasma Growth Hormone After an Overnight Fast and Following Glucose Loading in Healthy and Diabetic Subjects , Metabolism 15:596-607 ( (June) ) 1966.Crossref 30. Hernandez, A.; Zorilla, E.; and Gershberg, H.: Decreased Insulin Production, Elevated Growth Hormone Levels and Glucose Intolerance in Liver Disease , J Lab Clin Med 73:25-33 ( (Jan) ) 1969. 31. Pimstone, B., et al: Growth Hormone and Protein-Calorie Malnutrition , Lancet 2:1333-1334 ( (Dec 23) ) 1967.Crossref 32. Frantz, A.G., and Rabkin, M.T.: Effect of Estrogens and Sex Difference on Secretion of Human Growth Hormone , J Clin Endocr 25:1470-1480 ( (Nov) ) 1965.Crossref 33. Dohan, F.C., et al: Hormone Excretion in Liver Disease , J Clin Invest 31: 481-498 ( (May) ) 1952.Crossref 34. Rupp, J., et al: Hormone Excretion in Liver Disease and in Gynecomastia , J Clin Endocr 11:688-699 ( (July) ) 1951.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Internal Medicine American Medical Association

Serum Glucose, Insulin, and Growth Hormone in Chronic Hepatic Cirrhosis

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Publisher
American Medical Association
Copyright
Copyright © 1969 American Medical Association. All Rights Reserved.
ISSN
0003-9926
eISSN
1538-3679
DOI
10.1001/archinte.1969.00300180021004
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Abstract

Abstract Plasma glucose, radioimmunoassayable insulin, and growth hormone (HGH) concentrations were measured during oral glucose tolerance tests, (GTT) in 22 patients with chronic hepatic cirrhosis and in 15 normal subjects. Of the cirrhotics, 50% had normal results and 50% showed impaired glucose tolerance. Cirrhotic patients with normal results showed hyperinsulinism. Abnormal results for GTT were associated with hypoinsulinism compared with normal subjects. Fasting levels of HGH were higher than in normal subjects. During GTT, HGH levels in 18 cirrhotics were either not suppressed or showed paradoxical rise but normal subjects had complete suppression. Patients with hepatic cirrhosis and abnormal GTT results had higher HGH levels at 60, 90, and 120 minutes compared with patients with normal GTT results. High HGH levels may be responsible for the high incidence of abnormal glucose tolerance in hepatic cirrhosis and hyperinsulinism preceding hypoinsulinism. References 1. Naunyn, D.: Der Diabetes mellitus , ed 2, Vienna: Holder, 1906, pp 128-139. 2. Bloodworth, J.M.B., Jr.: Diabetes Mellitus and Cirrhosis of the Liver , Arch Intern Med 108:695-701 ( (Nov) ) 1961.Crossref 3. Samaan, N.; Stillman, D.; and Fraser, R.: Abnormalities of Serum Insulin-Like Activity in Liver-Disease , Lancet 2:1287-1290 ( (Dec 22) ) 1962.Crossref 4. Debry, G., and Charles, J.: Etude des perturbations du métabolisme des glucides chez les sujets atteints de cirrhose hépatique , Diabete 13:151-168 ( (April-May) ) 1965. 5. Megyesi, C.; Samols, E.; and Marks, V.: Glucose Tolerance and Diabetes in Chronic Liver Disease , Lancet 2:1051-1055 ( (Nov 18) ) 1967.Crossref 6. Danowski, T.S., et al: Significance of Blood Sugar and Serum Electrolyte Changes in Cirrhosis Following Glucose, Insulin, Glucagon, or Epinephrine , Yale J Biol Med 29:361-375 ( (Dec) ) 1957. 7. Creutzfeldt, W.; Willie, D.; and Kaup, H.: Intravenous Injections of Glucose, Insulin, and Tolbutamide in Healthy Persons, Diabetics, Cirrhotics, and Patients With Insuloma: Together With a Contribution on the Diagnostic Value of Tolbutamide Tests , Deutsch Med Wschr 87: 2189-2195 ( (Oct) ) 1962.Crossref 8. Samaan, N., and Stone, D.: Growth Hormone and Serum Insulin in Response to a Glucose Load in Chronic Hepatic Cirrhosis, abstracted , J Lab Clin Med 70: 986 ( (Dec) ) 1967. 9. Morgan, C.R., and Lazarow, A.: Immunoassay of Insulin: Two Antibody System , Diabetes 12:115-126 ( (March-April) ) 1963. 10. Hunter, W.M., and Greenwood, F.C.: Radioimmunoelectrophoretic Assay for Human Growth Hormone , Biochem J 91: 43-56 ( (April) ) 1964. 11. Samaan, N.A., et al: Serum Placental Lactogen Levels During Pregnancy and in Trophoblastic Disease , J Clin Endocr 26:1303-1308 ( (Dec) ) 1966.Crossref 12. Schalch, D.S., and Parker, M.L.: A Sensitive Double Antibody Immunoassay for Human Growth Hormone in Plasma , Nature 203:1141-1142 ( (Sept) ) 1964.Crossref 13. Butterfield, W.J.H.: Summary of Results of the Bedford Diabetes Survey , Proc Roy Soc Med 57:196-202 ( (March) ) 1964. 14. Sonksen, P.H.. et al: Plasma Insulin: A Correlation Between Bioassay and Immunoassay , Brit Med J 2:209-210 ( (July 14) ) 1965.Crossref 15. Fraser, R., et al: The Augmented Insulin Tolerance Test for Detecting Insulin Resistance , J Endocr 25:299-307 ( (Dec) )) 1962.Crossref 16. Burt, R.L.: Peripheral Utilization of Glucose in Pregnancy; Insulin Tolerance , Obstet Gynec 7:658-664 ( (June) ) 1956. 17. Perley, M., and Kipnis, D.M.: Effect of Glucocorticoids on Plasma Insulin , New Eng J Med 274:1237-1241 ( (June 17) ) 1966.Crossref 18. Luft, R.; Cerasi, E.; and Hamberger, C.A.: Pathogenesis of Diabetes in Acromegaly , Acta Endocr 56:593-607 ( (Dec) ) 1967. 19. Kalkhoff, et al: Diabetogenic Factors Associated With Pregnancy , Trans Assoc Amer Phys 77:270-280, 1964. 20. Fajans, S.S., and Conn, J.W.: The Early Recognition of Diabetes Mellitus , Ann NY Acad Sci 82:208-218 ( (Sept) ) 1959.Crossref 21. Daughaday, W.H., and Kipnis, D.M.: The Growth-Promoting and Anti-insulin Actions of Somatotropin , Recent Progr Hormone Res 22:49-99, 1966. 22. Beck, P.; Parker, M.L.; and Daughaday, W.H.: Paradoxical Hypersecretion of Growth Hormone in Response to Glucose , J Clin Endocr 26:463-469 ( (April) ) 1966.Crossref 23. Josimovich, J.B., and McLaren, J.A.: Presence in Human Placenta and Term Serum of Highly Lactogenic Substance Immunologically Related to Pituitary Growth Hormone , Endocrinology 71:209-220 ( (Aug) ) 1962.Crossref 24. Samaan, N.; Yen, S.C.C.; and Pearson, O.H.: Serum Placental Lactogen Levels During Pregnancy and in Trophoblastic Disease , J Clin Endocr 26:1303-1308 ( (Dec) ) 1966.Crossref 25. Samaan, N., et al: Metabolic Effects of Placental Lactogen (HPL) in Man , J Clin Endocr 28:485-491 ( (April) ) 1968.Crossref 26. Zumoff, B., et al: Cortisol Metabolism in Cirrhosis , J Clin Invest 46:1735-1743 ( (Nov) ) 1967.Crossref 27. Peterson, R.E.: Adrenocortical Steroid Metabolism and Cortical Function in Liver Disease , J Clin Invest 39:320-331 ( (Feb) ) 1960.Crossref 28. Roth, J., et al: Secretion of Human Growth Hormone: Physiologic and Experimental Modifications , Metabolism 12: 577-579 ( (July) ) 1963. 29. Hunter, W.M.; Clarke, B.F.; and Duncan, L.J.P.: Plasma Growth Hormone After an Overnight Fast and Following Glucose Loading in Healthy and Diabetic Subjects , Metabolism 15:596-607 ( (June) ) 1966.Crossref 30. Hernandez, A.; Zorilla, E.; and Gershberg, H.: Decreased Insulin Production, Elevated Growth Hormone Levels and Glucose Intolerance in Liver Disease , J Lab Clin Med 73:25-33 ( (Jan) ) 1969. 31. Pimstone, B., et al: Growth Hormone and Protein-Calorie Malnutrition , Lancet 2:1333-1334 ( (Dec 23) ) 1967.Crossref 32. Frantz, A.G., and Rabkin, M.T.: Effect of Estrogens and Sex Difference on Secretion of Human Growth Hormone , J Clin Endocr 25:1470-1480 ( (Nov) ) 1965.Crossref 33. Dohan, F.C., et al: Hormone Excretion in Liver Disease , J Clin Invest 31: 481-498 ( (May) ) 1952.Crossref 34. Rupp, J., et al: Hormone Excretion in Liver Disease and in Gynecomastia , J Clin Endocr 11:688-699 ( (July) ) 1951.Crossref

Journal

Archives of Internal MedicineAmerican Medical Association

Published: Aug 1, 1969

References