c-peptide and Alcoholism

Topics: Adult; Alcoholism; Blood Glucose; C-Peptide; Calcinosis; Chronic Disease; Female; Humans; Islets of Langerhans Transplantation; Liver Function Tests; Pancreatectomy; Pancreatitis; Time Factors; Tomography, X-Ray Computed; Transplantation, Autologous

A decreased tolerance to carbohydrates has been reported in several studies of liver diseases, whereas only a few investigations have been performed in chronic noncirrhotic alcoholic patients with and without alcohol abstinence. The aim of this study was to evaluate in detail the metabolic portrait of six noncirrhotic alcoholics during the early phase of alcohol withdrawal by quantifying the main processes involved in glucose disappearance. Data from frequently sampled intravenous glucose tolerance tests (FSIGTs) were analyzed by means of the minimal model (MINMOD) approach, which provided measurements of the (prehepatic) beta-cell secretion and of insulin degradation in the liver, along with indexes of insulin sensitivity and glucose effectiveness. Plasma insulin levels were lower in the patients (basal, 3.5 +/- 0.2 v 8.0 +/- 1.8 in matching controls, P < .05; area under the curve, 1.41 +/- 0.07 mU/mL in 240 minutes v 4.06 +/- 0.37, P < .001), and C-peptide concentrations were higher (basal, 107 +/- 3.5 v 36 +/- 9 ng/dL in controls, P < .05; area under the curve, 492 +/- 118 ng/mL in 240 minutes v 245 +/- 66, P = .05). The model analysis confirmed the absence of a decrease beta-cell release; in fact, in the alcoholics there was a basal secretion of 19 +/- 5 versus 9 +/- 2 pmol/L/min in controls (P < .05) and a total release of 9.5 +/- 1.8 nmol/L in 240 minutes versus 6.5 +/- 1.4.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Adult; Aged; Alcoholism; Biopsy; Blood Glucose; C-Peptide; Ethanol; Female; Glucose Tolerance Test; Humans; Insulin; Islets of Langerhans; Liver; Male; Mathematics; Middle Aged; Models, Biological; Substance Withdrawal Syndrome; Time Factors

Chronic alcohol consumers may have, as judged by functional criteria, exocrine as well as endocrine pancreatic dysfunction, the latter represented by a decreased insulin response to an oral glucose load. To investigate whether this decreased insulin response was due to an ethanol-induced beta-cell dysfunction or to an ethanol-induced dysfunction of the enteroinsular axis, we determined glucose, insulin, and C-peptide plasma concentrations following an oral and an intravenous glucose load in 16 healthy volunteer nonalcohol consumers and in 10 chronic alcohol consumers. In each group, total integrated response for glucose did not significantly change whether glucose was given orally or intravenously, indicating isoglycemic glucose loads. The total integrated response values for insulin in the alcoholic group following both glucose loads as well as C-peptide plasma concentrations were significantly lower than in the control group. Moreover, in both groups the insulin TIR values following the oral glucose load were significantly greater than the values obtained following the intravenous glucose load, indicating an incretin effect. These results indicate that the decreased insulin response observed in alcoholics was not caused by a dysfunction of the enteroinsular axis because it also occurred following an intravenous glucose load, but by an ethanol-induced beta-cell dysfunction because C-peptide and insulin were proportionally decreased in this group.

Topics: Adult; Alcoholism; Blood Glucose; C-Peptide; Female; Humans; Insulin; Insulin Secretion; Islets of Langerhans; Male; Middle Aged

The examination of 170 patients with chronic alcohol pancreatitis revealed diabetes mellitus (DM) in 21% of them. It manifested with polydipsia, polyuria and weight loss along with pancreatitis symptoms. DM complications were rare. Exercise tests were indicative of reduced insulin and glycagon reserves in the majority of the examinees. This condition depended on pancreatitis severity. DM in pancreatitis presents a high risk of hypoglycemia which should be taken into consideration when designing schemes of relevant treatment.

Topics: Adult; Alcoholism; Blood Glucose; C-Peptide; Chronic Disease; Diabetes Mellitus; Female; Glucagon; Glucose; Humans; Insulin; Islets of Langerhans; Male; Pancreatitis; Time Factors

Topics: Alcohol Drinking; Alcoholism; Blood Glucose; C-Peptide; Glucagon; Humans; Hypoglycemia; Insulin; Radioimmunoassay

Thirty patients suffering from chronic alcoholic pancreatitis (18 calcified) were entered into a study of exocrine and endocrine pancreatic function based on two maximal stimulation tests, namely the secretin-cerulein test and the glucagon test with serum assays of C peptide. The glucagon test was also performed in 19 control subjects. In addition, 10 chronic pancreatitis patients and nine controls were subjected to an oral glucose tolerance test (OGTT) with serum insulin determinations. C peptide basal values were decreased only in patients with severe pancreatic exocrine insufficiency (P less than 0.001), while delta C peptide values were also reduced in patients with moderate exocrine insufficiency (P less than 0.001). Lipase output correlated very well with delta C peptide values (P less than 0.001). While serum insulin levels during OGTT and C peptide basal values showed no significant differences between the chronic pancreatitis and control groups, delta C peptide values were significantly reduced in chronic pancreatitis patients (P less than 0.02). Both endocrine and exocrine function are impaired in chronic pancreatitis, as demonstrated by maximal tests, even in early stages of the disease.

Topics: Adult; Alcoholism; C-Peptide; Ceruletide; Chronic Disease; Female; Glucagon; Glucose Tolerance Test; Humans; Insulin; Islets of Langerhans; Male; Middle Aged; Pancreas; Pancreatic Function Tests; Pancreatitis; Secretin

Topics: Adult; Alcoholism; C-Peptide; Humans; Insulin; Islets of Langerhans; Male; Middle Aged

The results of puncture biopsy of the liver, ultrasonic and angiographic investigation of the liver and pancreas in 114 patients with chronic alcoholism revealed an increment of changes in these organs in parallel with an increase in the duration of chronic alcoholic intoxication. A simultaneous study of immunoreactive insulin (IRI) and C-peptide showed that an increase in the IRI basal level in the patients suffering from alcoholism up to 10 yrs was determined mainly by an increase in the activity of beta-cells. In a long period of alcoholism an increase in the IRI basal level resulted from a decrease in the rate of insulin degradation in the liver as assessed by a lower level of C-peptide. In liver cirrhosis a noticeable decrease in pancreatic incretory function was combined with noticeable disturbance of insulin degradation in the liver. The above investigations showed that there were morphological, functional and clinical signs of the "hepatopancreatic syndrome" in chronic alcoholism.

Topics: Adult; Alcoholism; C-Peptide; Glucose Tolerance Test; Humans; Insulin; Liver Diseases, Alcoholic; Male; Middle Aged; Pancreatic Diseases; Syndrome; Time Factors

Insulin secretion was studied after stimulation with oral glucose and intravenous glucagon in 23 chronic alcoholics in a withdrawal state. Each subject was studied twice at one week's interval between the examinations. The insulin and C-peptide responses to glucagon were lower in the early withdrawal state. Moreover, the insulin and C-peptide increments were, when related to the magnitude of the glycemic stimulus, lower in the early than in the late withdrawal state. The fasting values of blood glucose, insulin and C-peptide and the blood glucose and C-peptide levels after oral glucose were higher in the early withdrawal state. These findings indicate that glucose metabolism in alcoholics in a withdrawal state can be disturbed by impaired insulin secretion and insulin resistance.

Topics: Adult; Aged; Alcoholism; Blood Glucose; C-Peptide; Ethanol; Female; Glucagon; Glucose; Humans; Insulin; Insulin Secretion; Islets of Langerhans; Male; Middle Aged; Substance Withdrawal Syndrome; Time Factors

Endocrine function of the pancreas was examined in patients with chronic pancreatitis of different etiology. Radioimmunoassay was applied to measure blood immunoreactive insulin, C-peptide and glucagon as characteristics of the hormonal activity of the pancreas. Pancreatic function was revealed to be disordered. The degree of the disorders correlated with the disease gravity and duration as well as with its progress (exacerbation or remission). As compared with patients presenting with cholepancreatitis, more remarkable alterations, which were particularly well observable during making the glucose tolerance test, were found in patients with chronic pancreatitis of alcoholic etiology.

Topics: Alcoholism; Blood Glucose; C-Peptide; Chronic Disease; Fatty Liver; Female; Glucagon; Humans; Insulin; Insulin Secretion; Islets of Langerhans; Male; Pancreatitis; Proinsulin

Glucose tolerance and B cell function were assessed in 30 consecutive chronic alcoholic patients without overt diabetes mellitus. Plasma glucose, insulin, and C peptide concentrations were measured during an oral glucose tolerance test. All patients underwent a liver biopsy and an exocrine pancreatic function test (Lundh test). Compared with the controls, the three groups of alcoholic patients (those with histologically normal livers, n = 12; those with steatosis, n = 10; and those with cirrhosis, n = 8) all had a two-fold increase in plasma concentrations of insulin as well as C peptide in the fasting state, despite normal fasting levels of glucose. After oral glucose all groups of patients had elevated plasma levels of glucose, insulin, and C peptide compared with the controls. The C peptide/insulin ratio was similar to that in the controls in all groups of alcoholics. Patients with decreased exocrine pancreatic function (n = 7) had a significantly lower insulin and C peptide response to glucose than the patients with normal exocrine pancreatic function. It is concluded that (1) chronic alcoholics even with histologically normal livers have endogenous insulin resistance, and (2) associated damage to the exocrine pancreas is more common than previously recognized and decompensation of B cell function could be demonstrated in patients with decreased exocrine pancreatic secretion.

Topics: Adolescent; Adult; Alcoholism; Blood Glucose; C-Peptide; Glucose Tolerance Test; Humans; Insulin; Islets of Langerhans; Liver; Liver Cirrhosis, Alcoholic; Male; Middle Aged; Pancreas

Insulin effect was investigated in 20 chronic alcoholics by use of an insulin and glucose infusion which suppressed endogenous insulin secretion. It was found that the effect of insulin was lower during the first week than the second week of alcohol withdrawal.

Topics: 3-Hydroxybutyric Acid; Adult; Aged; Alcoholism; Blood Glucose; C-Peptide; Growth Hormone; Humans; Hydroxybutyrates; Insulin; Male; Middle Aged; Substance Withdrawal Syndrome; Time Factors