HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Purchase Article View Shopping Cart Alert me when this article is cited Alert me if a correction is posted Citation Map Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Perseghin, G. Articles by Luzi, L. Search for Related Content PubMed PubMed Citation Articles by Perseghin, G. Articles by Luzi, L. Agricola Articles by Perseghin, G. Articles by Luzi, L.

Resting energy expenditure in diabetic and nondiabetic patients with liver cirrhosis: relation with insulin sensitivity and effect of liver transplantation and immunosuppressive therapy^1,2,3

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 (S_I(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, S_I(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.

Key Words: Resting energy expenditure • liver cirrhosis • insulin resistance • liver transplantation • lipid oxidation • immunosuppressive therapy • diabetes

This article has been cited by other articles:

				G. Perseghin, M. Comola, P. Scifo, S. Benedini, F. De Cobelli, R. Lanzi, F. Costantino, G. Lattuada, A. Battezzati, A. Del Maschio, et al. Postabsorptive and insulin-stimulated energy and protein metabolism in patients with myotonic dystrophy type 1 Am. J. Clinical Nutrition, August 1, 2004; 80(2): 357 - 364. [Abstract] [Full Text] [PDF]