Liver metabolism

肝脏代谢
  • 文章类型: Journal Article
    缺铁是全球头号营养问题。铁的摄取在肠道受到调节,并受到肠道微生物组的高度影响。肠道的血液直接流入肝脏,告知铁状态和肠道微生物群状态。铁或微生物组的变化与代谢功能障碍相关的脂肪变性肝病(MASLD)的发展密切相关。探讨铁代谢改变与肠道菌群连接的MASLD发育的潜在机制,我们比较了无特定病原体(SPF)或无菌(GF)小鼠,正常或低铁饮食。低铁饮食的SPF小鼠显示血清甘油三酯和MASLD降低。相比之下,GF低铁饮食喂养的小鼠显示血清甘油三酯增加,并且没有发生肝性脂肪变性。SPF小鼠显示肝脏脂质代谢的显着变化和胰岛素抵抗的增加,这取决于肠道微生物群的存在。我们报告说,在低铁饮食中,线粒体铁进口商Mitoferrin2(Mfrn2-/-)的全身丢失加剧了MASLD的发展,并伴有明显的脂质代谢改变。我们的研究表明,肠道微生物组有明显的贡献,膳食铁,和Mfrn2在MASLD和代谢综合征的发展中的作用。
    Iron deficiency is the number one nutritional problem worldwide. Iron uptake is regulated at the intestine and is highly influenced by the gut microbiome. Blood from the intestines drains directly into the liver, informing iron status and gut microbiota status. Changes in either iron or the microbiome are tightly correlated with the development of metabolic dysfunction-associated steatotic liver disease (MASLD). To investigate the underlying mechanisms of the development of MASLD that connect altered iron metabolism and gut microbiota, we compared specific pathogen free (SPF) or germ-free (GF) mice, fed a normal or low-iron diet. SPF mice on a low-iron diet showed reduced serum triglycerides and MASLD. In contrast, GF low-iron diet-fed mice showed increased serum triglycerides and did not develop hepatic steatosis. SPF mice showed significant changes in liver lipid metabolism and increased insulin resistance that was dependent upon the presence of the gut microbiota. We report that total body loss of mitochondrial iron importer Mitoferrin2 (Mfrn2-/-) exacerbated the development of MASLD on a low-iron diet with significant lipid metabolism alterations. Our study demonstrates a clear contribution of the gut microbiome, dietary iron, and Mfrn2 in the development of MASLD and metabolic syndrome.
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  • 文章类型: Journal Article
    目的:从IVF后代到后代的代谢表型的潜在传递是什么?
    方法:建立了IVF小鼠模型。通过IVF或自然交配产生F1代小鼠,并通过F1代雄性与正常雌性交配获得F2代小鼠。他们的代谢表型,包括全身和肝脏糖脂代谢,被检查过。
    结果:发现IVFF1男性表现出代谢变化。与对照组相比,IVFF1一代显示体重增加,空腹血糖和胰岛素升高,和增加血清甘油三酯浓度。IVFF1小鼠还显示肝脏脂肪生成和自噬基因的表达增加。此外,在没有饮食挑战的情况下,IVFF1雄性将一些代谢变化传递给自己的雄性后代(IVFF2)。IVFF2小鼠的附睾周围和皮下脂肪增加,胰岛素敏感性降低。在高脂肪饮食的“第二次打击”下,IVFF2小鼠进一步显示肝脏脂质沉积增加,自噬水平未改变。
    结论:这项研究证明了IVF对连续两代后代肝脏糖脂代谢的影响,强调需要进一步调查。增强对IVF引起的多代效应传递的潜在机制的理解可能会导致对经历不孕症的个体的治疗干预措施的进步。
    OBJECTIVE: What is the potential transmission of metabolic phenotype from IVF offspring to the subsequent generation?
    METHODS: An IVF mouse model was established. The F1 generation mice were produced though IVF or natural mating and the F2 generation was obtained through the mating of F1 generation males with normal females. Their metabolic phenotype, including systemic and hepatic glucolipid metabolism, was examined.
    RESULTS: It was found that IVF F1 males exhibited metabolic changes. Compared with the control group, the IVF F1 generation showed increased body weight, elevated fasting glucose and insulin, and increased serum triglyceride concentrations. IVF F1 mice also showed an increased expression of hepatic lipogenesis and autophagy genes. Moreover, IVF F1 males transmitted some metabolic changes to their own male progeny (IVF F2) in the absence of a dietary challenge. IVF F2 mice had increased peri-epididymal and subcutaneous fat and decreased insulin sensitivity. Under the \'second hit\' of a high-fat diet, IVF F2 mice further showed increased hepatic lipid deposition with unaltered autophagy levels.
    CONCLUSIONS: This research demonstrates the impact of IVF on hepatic glucose-lipid metabolism in two successive generations of offspring, highlighting the need for additional investigation. Enhanced understanding of the mechanisms underlying the transmission of multigenerational effects induced by IVF could potentially lead to the advancement of therapeutic interventions for individuals experiencing infertility.
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  • 文章类型: Journal Article
    缬氨酸的集中管理已被证明会导致鱼类的饮食过多。尽管雷帕霉素的机制靶标(mTOR)参与了这种反应,过量缬氨酸对中枢和外周代谢产物采食量变化的影响尚不清楚.在这里,我们研究了脑室(ICV)注射缬氨酸是否会调节中枢和外周代谢物的分布,并可能为鱼类的摄食反应提供见解。幼年虹鳟鱼(Oncorhynchusmykiss)注射了缬氨酸(10µg·µL-1,体重为1μL·100g-1)和血浆中的代谢物谱,下丘脑,和大脑的其余部分(包括端脑,视神经顶盖,小脑,和延髓)通过基于液相色谱-质谱(LC/MS)的代谢组学进行。在大脑中注射后1小时,缬氨酸的施用导致了空间上不同的代谢物分布:在大脑的其余部分而不是下丘脑中,氨基酸代谢和能量产生途径的富集。这表明下丘脑外输入在调节采食量中的作用。此外,有几种氨基酸的富集,包括酪氨酸,脯氨酸,缬氨酸,苯丙氨酸,和蛋氨酸,血浆中对缬氨酸的反应。肝脏转录物丰度和蛋白质表达的变化反映了代谢能力的增加,包括葡萄糖和脂肪酸产生的能量,和缬氨酸组中较低的蛋白激酶B(Akt)磷酸化。总之,缬氨酸ICV给药影响虹鳟鱼的中枢和外周代谢,我们提出了改变的代谢物谱在调节对这种支链氨基酸的摄食反应中的作用。
    Central administration of valine has been shown to cause hyperphagia in fish. Although mechanistic target of rapamycin (mTOR) is involved in this response, the contributions on feed intake of central and peripheral metabolite changes due to excess valine are unknown. Here we investigated whether intracerebroventricular (ICV) injection of valine modulates central and peripheral metabolite profiles and may provide insights into feeding response in fish. Juvenile rainbow trout (Oncorhynchus mykiss) were administered an ICV injection of valine (10 µg · µL-1 at 1 μL·100 g-1 body weight) and the metabolite profile in plasma, hypothalamus, and rest of the brain (comprising of telencephalon, optic tectum, cerebellum, and medulla oblongata) was carried out by liquid chromatography-mass spectrometry (LC/MS)-based metabolomics. Valine administration led to a spatially distinct metabolite profile at 1 h post-injection in the brain: enrichment of amino acid metabolism and energy production pathways in the rest of the brain but not in hypothalamus. This suggests a role for extrahypothalamic input in the regulation of feed intake. Also, there was enrichment of several amino acids, including tyrosine, proline, valine, phenylalanine, and methionine, in plasma in response to valine. Changes in liver transcript abundance and protein expression reflect an increased metabolic capacity, including energy production from glucose and fatty acids, and a lower protein kinase B (Akt) phosphorylation in the valine group. Altogether, valine ICV administration affects central and peripheral metabolism in rainbow trout, and we propose a role for the altered metabolite profile in modulating the feeding response to this branched-chain amino acid.
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  • 文章类型: Journal Article
    年轻女性维生素D缺乏的风险增加,这可能会增加乳腺癌的发病率。这里,我们评估了维生素D在幼发乳腺癌小鼠模型中的抗癌功效.在从未怀孕的老鼠中,补充维生素D可增加血清25(OH)D和肝脏1,25(OH)2D3,减小肿瘤大小,并与抗肿瘤免疫有关。这些抗肿瘤作用在产后乳腺癌小鼠模型中没有复制,断奶后维生素D的肝脏代谢受到抑制,导致血清25(OH)D缺乏,肝脏1,25(OH)2D3减少。用活性1,25(OH)2D3治疗仅在断奶后小鼠中诱导高钙血症,强调断奶后代谢失衡。RNAseq显示产后CYP450表达受抑制。总之,我们提供的证据表明,维生素D抗肿瘤活性是通过免疫调节机制介导的,并且由于肝脏代谢改变,在断奶后窗口无效。这些发现对产后妇女体内抑制的外源性生物代谢具有意义,超过维生素D。
    在产后乳腺癌的啮齿动物模型中,断奶抑制肝脏CYP450活性,使补充维生素D无效,对异种生物药物的疗效和安全性有影响。根据生育史量身定制的治疗方法对年轻乳腺癌患者至关重要,以及产后妇女的保健策略。
    Young women have increased risk of vitamin D deficiency, which may increase breast cancer incidence. Here, we assessed the anti-cancer efficacy of vitamin D in mouse models of young-onset breast cancer. In never-pregnant mice, vitamin D supplementation increased serum 25(OH)D and hepatic 1,25(OH)2D3, reduced tumor size, and associated with anti-tumor immunity. These anti-tumor effects were not replicated in a mouse model of postpartum breast cancer, where hepatic metabolism of vitamin D was suppressed post-wean, which resulted in deficient serum 25(OH)D and reduced hepatic 1,25(OH)2D3. Treatment with active 1,25(OH)2D3 induced hypercalcemia exclusively in post-wean mice, highlighting metabolic imbalance post-wean. RNAseq revealed suppressed CYP450 expression postpartum. In sum, we provide evidence that vitamin D anti-tumor activity is mediated through immunomodulatory mechanisms and is ineffective in the post-wean window due to altered hepatic metabolism. These findings have implications for suppressed xenobiotic metabolism in postpartum women beyond vitamin D.
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  • 文章类型: Journal Article
    超极化[2-13C,在这项研究中研究了3-2H3]丙酮酸用于体内探索糖异生的作用。而超极化的[1-13C]丙酮酸可以清晰地进入将丙酮酸转化为乳酸的代谢途径,丙氨酸,和碳酸氢盐,其用于评估丙酮酸羧化和糖异生的效用受到技术挑战的限制,包括光谱重叠和使标记碳脱羧的模糊酶促步骤。为了实现糖异生产物的明确检测,丙酮酸中的羰基碳用13C标记。为了延长T1弛豫时间,[2-13C,合成了3-2H3]丙酮酸盐,并在动态核极化后用D2O溶解。[2-13C的T1,与水中的[2-13C]丙酮酸相比,D2O中的3-2H3]丙酮酸可提高76.9%(1T时为79.6s,3T时为74.5s)。超极化[2-13C,将具有D2O溶解的3-2H3]丙酮酸盐在正常进食和禁食条件下体内应用于大鼠肝脏。一种糖异生产品,[2-13C]磷酸烯醇丙酮酸,仅在禁食大鼠中观察到149.9ppm,强调[2-13C,3-2H3]丙酮酸在体内检测关键的糖异生酶活性如丙酮酸羧化酶和磷酸烯醇丙酮酸羧激酶。
    The feasibility of hyperpolarized [2-13C, 3-2H3]pyruvate for probing gluconeogenesis in vivo was investigated in this study. Whereas hyperpolarized [1-13C]pyruvate has clear access to metabolic pathways that convert pyruvate to lactate, alanine, and bicarbonate, its utility for assessing pyruvate carboxylation and gluconeogenesis has been limited by technical challenges, including spectral overlap and an obscure enzymatic step that decarboxylates the labeled carbon. To achieve unambiguous detection of gluconeogenic products, the carbonyl carbon in pyruvate was labeled with 13C. To prolong the T1 relaxation time, [2-13C, 3-2H3]pyruvate was synthesized and dissolved with D2O after dynamic nuclear polarization. The T1 of [2-13C, 3-2H3]pyruvate in D2O could be improved by 76.9% (79.6 s at 1 T and 74.5 s at 3 T) as compared to [2-13C]pyruvate in water. Hyperpolarized [2-13C, 3-2H3]pyruvate with D2O dissolution was applied to rat livers in vivo under normal feeding and fasting conditions. A gluconeogenic product, [2-13C]phosphoenolpyruvate, was observed at 149.9 ppm from fasted rats only, highlighting the utility of [2-13C, 3-2H3]pyruvate in detecting key gluconeogenic enzyme activities such as pyruvate carboxylase and phosphoenolpyruvate carboxykinase in vivo.
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  • 文章类型: Journal Article
    最近的研究表明,早期生活干预策略在影响产后发育过程中的显着潜力,从而为延长寿命和改善整体健康提供令人兴奋的可能性。二甲双胍(MF),FDA批准的治疗II型糖尿病的药物,最近因其有前途的抗老化性能而受到关注,作为热量限制的模拟,延缓性早熟.此外,trodusquemine(MSI-1436),一种研究药物,已被证明可以通过抑制酶蛋白酪氨酸磷酸酶1b(Ptp1b)来对抗肥胖和代谢紊乱,从而减少肝脏脂肪生成并抵消胰岛素和瘦素抵抗。在这项研究中,我们旨在进一步探索这些化合物对年轻人的影响,开发小鼠以发现对肝脏代谢过程至关重要的生物分子特征。我们发现,与MF相比,MSI-1436更有效地改变肝脏中的mRNA和miRNA表达,生物信息学分析表明,差异表达的miRNAs队列抑制磷酸肌醇3-激酶(Pi3k)的作用,蛋白激酶B(Akt),和哺乳动物雷帕霉素靶蛋白(Mtor)来调节从头脂肪生成的下游过程,脂肪酸氧化,极低密度脂蛋白转运,胆固醇生物合成和外排。总之,我们的研究表明,在出生后窗口施用这些化合物通过诱导转录组的有效表观遗传变化代谢重新编程肝脏,有可能预防与年龄有关的疾病的发作并延长寿命。未来的研究是必要的,以确定对寿命和整体生活质量的影响。
    Recent studies have demonstrated the remarkable potential of early life intervention strategies at influencing the course of postnatal development, thereby offering exciting possibilities for enhancing longevity and improving overall health. Metformin (MF), an FDA-approved medication for type II diabetes mellitus, has recently gained attention for its promising anti-aging properties, acting as a calorie restriction mimetic, and delaying precocious puberty. Additionally, trodusquemine (MSI-1436), an investigational drug, has been shown to combat obesity and metabolic disorders by inhibiting the enzyme protein tyrosine phosphatase 1b (Ptp1b), consequently reducing hepatic lipogenesis and counteracting insulin and leptin resistance. In this study, we aimed to further explore the effects of these compounds on young, developing mice to uncover biomolecular signatures that are central to liver metabolic processes. We found that MSI-1436 more potently alters mRNA and miRNA expression in the liver compared with MF, with bioinformatic analysis suggesting that cohorts of differentially expressed miRNAs inhibit the action of phosphoinositide 3-kinase (Pi3k), protein kinase B (Akt), and mammalian target of rapamycin (Mtor) to regulate the downstream processes of de novo lipogenesis, fatty acid oxidation, very-low-density lipoprotein transport, and cholesterol biosynthesis and efflux. In summary, our study demonstrates that administering these compounds during the postnatal window metabolically reprograms the liver through induction of potent epigenetic changes in the transcriptome, potentially forestalling the onset of age-related diseases and enhancing longevity. Future studies are necessary to determine the impacts on lifespan and overall quality of life.
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  • 文章类型: Journal Article
    未折叠蛋白应答(UPR)是当错误折叠蛋白在内质网(ER)中积累时被激活的细胞应激反应。UPR应答的调节必须适应细胞的需要,因为延长的UPR应答可导致破坏的细胞功能和组织损伤。以前,我们发现,酶FicD(也称为Fic或HYPE)通过其AMPylation和脱AMPylation活性可以通过BiP的翻译后修饰来调节UPR反应。FicD在稳态期间对BiP进行AMPylate,在应激期间对BiP进行脱AMPylate。我们假设FicD对UPR的调节将在减轻经常生理应激的组织中UPR激活的有害作用中发挥作用。这里,我们探讨了FicD在小鼠肝脏中的作用。从我们的胰腺研究中可以看出,缺乏FicD的肝脏在短期生理禁食和进食压力下表现出增强的UPR信号传导。然而,与对胰腺的研究相反,肝脏,作为一种更再生的组织,在没有FicD的情况下保持了显著的弹性。在慢性高脂饮食(HFD)喂养或急性病理性UPR诱导后,FicD-/-的肝脏未显示UPR信号传导或损伤的显着变化。有趣的是,FicD-/-小鼠在反复病理性UPR诱导后显示UPR诱导和体重减轻模式的变化。这些发现表明,FicD在轻度生理应激和适应重复应激时调节UPR反应,但对FicD调节的要求存在组织特异性差异。
    The unfolded protein response (UPR) is a cellular stress response that is activated when misfolded proteins accumulate in the endoplasmic reticulum (ER). Regulation of the UPR response must be adapted to the needs of the cell as prolonged UPR responses can result in disrupted cellular function and tissue damage. Previously, we discovered that the enzyme FicD (also known as Fic or HYPE) through its AMPylation and deAMPylation activity can modulate the UPR response via post-translational modification of BiP. FicD AMPylates BiP during homeostasis and deAMPylates BiP during stress. We hypothesized that FicD regulation of the UPR will play a role in mitigating the deleterious effects of UPR activation in tissues with frequent physiological stress. Here, we explore the role of FicD in the murine liver. As seen in our pancreatic studies, livers lacking FicD exhibit enhanced UPR signaling in response to short term physiologic fasting and feeding stress. However, in contrast to studies on the pancreas, livers, as a more regenerative tissue, remained remarkably resilient in the absence of FicD. The livers of FicD-/- did not show marked changes in UPR signaling or damage after either chronic high fat diet (HFD) feeding or acute pathological UPR induction. Intriguingly, FicD-/- mice showed changes in UPR induction and weight loss patterns following repeated pathological UPR induction. These findings indicate that FicD regulates UPR responses during mild physiological stress and in adaptation to repeated stresses, but there are tissue specific differences in the requirement for FicD regulation.
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  • 文章类型: Journal Article
    最近的全基因组关联研究已经确定了线粒体胺肟减少成分1(mARC1)中的错义变体p.A165T,其与非酒精性脂肪性肝炎(NASH)的全因肝硬化保护和预后改善密切相关。这种保护作用的确切机制是未知的。预测用苏氨酸取代丙氨酸165会影响mARC1蛋白的稳定性,并对其功能产生有害影响。为了研究机制,我们在人肝癌HepG2细胞中产生了敲入突变体mARC1A165T和催化死亡突变体C273A(作为对照),能够表征蛋白质亚细胞分布,稳定性,和从其内源性基因座表达的mARC1突变蛋白的生化功能。与野生型(WT)mARC1相比,我们发现A165T突变体在其锚定在线粒体外膜的传统位置之外表现出明显的错误定位,并降低了蛋白质的稳定性,导致较低的基础水平。我们评估了泛素蛋白酶体系统在mARC1A165T降解中的参与,并观察到A165T变体的泛素化增加和降解更快。此外,我们已经表明,携带MTARC1p.A165T变体的HepG2细胞在体外对外源添加的胺肟底物表现出较低的N-还原活性。来自这些生化和功能测定的数据表明MTARC1p.A165T变体消除酶功能的机制,这可能有助于其在肝病中的保护作用。
    Recent genome-wide association studies have identified a missense variant p.A165T in mitochondrial amidoxime-reducing component 1 (mARC1) that is strongly associated with protection from all-cause cirrhosis and improved prognosis in nonalcoholic steatohepatitis. The precise mechanism of this protective effect is unknown. Substitution of alanine 165 with threonine is predicted to affect mARC1 protein stability and to have deleterious effects on its function. To investigate the mechanism, we have generated a knock-in mutant mARC1 A165T and a catalytically dead mutant C273A (as a control) in human hepatoma HepG2 cells, enabling characterization of protein subcellular distribution, stability, and biochemical functions of the mARC1 mutant protein expressed from its endogenous locus. Compared to WT mARC1, we found that the A165T mutant exhibits significant mislocalization outside of its traditional location anchored in the mitochondrial outer membrane and reduces protein stability, resulting in lower basal levels. We evaluated the involvement of the ubiquitin proteasome system in mARC1 A165T degradation and observed increased ubiquitination and faster degradation of the A165T variant. In addition, we have shown that HepG2 cells carrying the MTARC1 p.A165T variant exhibit lower N-reductive activity on exogenously added amidoxime substrates in vitro. The data from these biochemical and functional assays suggest a mechanism by which the MTARC1 p.A165T variant abrogates enzyme function which may contribute to its protective effect in liver disease.
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  • 文章类型: Journal Article
    法尼醇X受体(FXR)在90年代后期被鉴定为类似于类固醇受体的孤儿核受体。FXR的激活是肝脏许多生理功能中的关键步骤。FXR的一个重要作用是影响肝细胞中胆汁酸的量,它通过减少胆汁酸合成来执行,刺激胆盐出口泵,抑制它的肝肠循环,从而保护肝细胞免受胆汁酸的毒性积累。此外,FXR介导肠道胆汁酸生物转化,肝再生,葡萄糖止血,和脂质代谢。在这次审查中,我们首先讨论FXR激动剂不同多效作用的机制。然后,我们深入研究奥贝胆酸(OCA)的药代动力学,一流的选择性,有效的FXR激动剂。我们还讨论了OCA在人类中的临床旅程,它目前在各种人类疾病中的证据,以及它在未来可能扮演的角色。
    Farnesoid X receptor (FXR) was identified as an orphan nuclear receptor resembling the steroid receptor in the late \'90s. Activation of FXR is a crucial step in many physiological functions of the liver. A vital role of FXR is impacting the amount of bile acids in the hepatocytes, which it performs by reducing bile acid synthesis, stimulating the bile salt export pump, and inhibiting its enterohepatic circulation, thus protecting the hepatocytes against the toxic accumulation of bile acids. Furthermore, FXR mediates bile acid biotransformation in the intestine, liver regeneration, glucose hemostasis, and lipid metabolism. In this review, we first discuss the mechanisms of the disparate pleiotropic actions of FXR agonists. We then delve into the pharmacokinetics of Obeticholic acid (OCA), the first-in-class selective, potent FXR agonist. We additionally discuss the clinical journey of OCA in humans, its current evidence in various human diseases, and its plausible roles in the future.
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  • 文章类型: Journal Article
    肝源性糖尿病(HD)在肝硬化患者中经常被低估。目前的研究评估了震级,临床特征,与2型糖尿病(T2DM)和非糖尿病(ND)肝硬化患者相比,肝硬化患者中HD的意义。
    在一项前瞻性观察性研究中,对338例连续符合条件的肝硬化患者进行糖尿病筛查。使用2小时口服葡萄糖耐量试验(OGTT)来检测HD。临床特点,并发症,并在HD之间确定和比较结果,T2DM,ND患者。
    在316名患者的最终研究队列中,HD的比例,T2DM,ND为22.5%(n=71),26.3%(n=83),51.3%(n=162),分别。HD是Child-PughC级肝硬化中糖尿病的主要形式(68.9%)。大多数(73%)HD患者的OGTT异常,无空腹高血糖。空腹血糖的下限为98.5mg/dl,对于预测HD具有适度的敏感性(72%)和特异性(75%)。与T2DM患者相比,HD患者更年轻,leaner,患有更晚期的肝硬化。与ND患者相比,HD患者较瘦,但血糖指数较高,血清胆固醇,和动脉氨水平。在12(03-21)个月的中位随访期内,HD和T2DM患者的肝性脑病和静脉曲张出血发生率高于ND组.
    HD在约五分之一的肝硬化患者中普遍存在。它在许多方面与T2DM和ND不同,并与肝硬化并发症有关。
    UNASSIGNED: Hepatogenous diabetes (HD) is frequently underestimated among cirrhosis patients. The current study assessed the magnitude, clinical characteristics, and implications of HD in cirrhosis patients as compared to the patients with type-2 diabetes mellitus (T2DM) and non-diabetes (ND) cirrhosis.
    UNASSIGNED: In a prospective observational study, 338 consecutive eligible cirrhosis patients were screened for diabetes mellitus. A 2-hour oral glucose tolerance test (OGTT) was used to detect HD. The clinical characteristics, complications, and outcomes were ascertained and compared amongst HD, T2DM, and ND patients.
    UNASSIGNED: In the final study cohort of 316 patients, the proportion of HD, T2DM, and ND was 22.5% (n = 71), 26.3% (n = 83), and 51.3% (n = 162), respectively. HD was the predominant form of diabetes (68.9%) in Child-Pugh class-C cirrhosis. The majority (73%) of HD patients had abnormal OGTT without fasting hyperglycaemia. A lower cut-off of 98.5 mg/dl for fasting blood glucose had a modest sensitivity (72%) and specificity (75%) for predicting HD. In comparison to T2DM patients, HD patients were younger, leaner, and had more advanced cirrhosis. In comparison to ND patients, HD patients were leaner but had higher glycemic indices, serum cholesterol, and arterial ammonia levels. During a median follow-up period of 12 (03-21) months, the frequency of hepatic encephalopathy and variceal haemorrhage were higher in HD and T2DM patients compared to that in the ND group.
    UNASSIGNED: HD is prevalent in about one fifth of cirrhosis patients. It differs from T2DM and ND in a number of ways, and has association with complications of cirrhosis.
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