c-peptide and Hepatitis--Viral--Human

Topics: C-Peptide; Carbohydrate Metabolism; Glucose Tolerance Test; Hepatitis, Viral, Human; Humans; Hypoglycemia; Insulin; Insulin Resistance; Liver Cirrhosis; Liver Diseases

Insulin and glucagon are thought to play important roles as hepatotrophic factors in acute viral hepatitis (AVH); however, few reports have investigated the responses and relationships of each of these hormones to liver damage in detail. We studied insulin and glucagon responses during the acute and recovery phases of AVH. We performed a glucose tolerance test (GTT) and an insulin sensitivity test (IST) in each phase in 11 patients with AVH. In 8 additional patients in the acute phase (total n = 19), were compared immunoreactive insulin (IRI) and C-peptide immunoreactivity (CPR) levels with transaminase levels. In the acute phase, IRI concentrations were normal from fasting to 60 min, despite an increased CPR level. In the recovery phase, IRI and CPR levels increased significantly. Immunoreactive glucagon levels in both phases did not differ significantly from those in controls. During the IST, the insulin sensitivity index in both phases was significantly lower than that in the controls. Fasting IRI and sigma IRI showed significant negative correlations with transaminase levels. We found enhanced insulin secretion and a decrease in plasma insulin in the acute phase of AVH. The discrepancy between IRI and CPR responses in the acute phase suggests an increase in the degradation or consumption of insulin in the liver.

Topics: Acute Disease; Adolescent; Adult; Blood Glucose; C-Peptide; Female; Glucagon; Glucose Tolerance Test; Hepatitis, Viral, Human; Humans; Insulin; Male; Middle Aged; Transaminases

Levels of plasma cyclic AMP, serum immunoreactive insulin (IRI), serum c-peptide immunoreactivity (CPR) and blood sugar (BS) were determined 0, 15, 30, 45 and 60 min after a glucagon injection (0.01 mg per kg body weight) in normal controls, patients with acute hepatitis and liver cirrhosis. Plasma cyclic AMP responses to glucagon in liver disease patients varied widely in peak value, and only in patients with fulminant hepatitis and decompensated liver cirrhosis with poor prognosis was the response suppressed. The peak response of BS was found significantly later in liver cirrhosis patients than in normal controls. IRI and CPR responses to glucagon were lower in acute hepatitis patients than in normal controls and liver cirrhosis patients. IRI levels and their sum were also lower in acute hepatitis patients, although CPR levels were not significantly different. Thus, the ratio of the sum of CPR from 0 to 60 min to that of IRI was significantly higher in acute hepatitis, indicating impaired pancreatic secretion of insulin to glucagon stimulation as well as increased uptake of insulin by the liver in acute hepatitis.

Topics: Adult; Blood Glucose; C-Peptide; Cyclic AMP; Female; Glucagon; Hepatitis, Viral, Human; Humans; Insulin; Kinetics; Liver Cirrhosis; Liver Diseases; Male; Middle Aged

Carbohydrate intolerance with high insulin levels are a consistent finding in acute and chronic liver diseases. It has been recently clarified that in cirrhotic patients hyperinsulinism is related to decreased hepatic clearance, but the role of liver cell damage or portal systemic shuntings is still unclear. Therefore, we assessed glucose, immunoreactive insulin (IRI) and C-peptide immunoreactivity (CPR), in the basal state and after oral and intravenous glucose load, in fifteen patients with acute viral hepatitis (AVH), a liver disease where cell necrosis is prominent. CPR is a useful tool for investigation of hyperinsulinism as, according to previous reports, it is not - or is only to a limited degree - metabolised by the liver. Our results confirm the carbohydrate intolerance, with high IRI levels, in the early stage of AVH. CPR levels were significantly increased before and after glucose load. This study suggests that liver cell damage plays a key role in the pathogenesis of hyperinsulinism in liver diseases and high CPR values seem also to be related to liver damage.

Topics: Adult; Blood Glucose; C-Peptide; Carbohydrate Metabolism; Female; Glucose Tolerance Test; Hepatitis, Viral, Human; Humans; Insulin; Male; Peptides

On 35 patients with acute hepatitis had been carried out intravenous glucose-tolerance-tests (0,5 g glucose/kg). The assimilation coefficient of glucose and the level of insulin were determined during the acute phase of illness and the recovery phase. In 8 cases additionally C-peptide was determined to interpret the regulation of insulin-secretion and hepatic reduction. During the acute phase of illness the glucose-tolerance-test proofed 15 x clearly and 13 x limiting pathological. Except one patient all cases showed an improvement during recovery and 21 x a normalisation of glucose-tolerance. The serum-insulin-analysis gave 28 x lower figures during the acute phase compared to the healing-phase, whereas the determination of the C-peptide showed higher figures matching the enhanced glucose concentrations, which proves a normal regulation of insulin-secretion during the acute phase of disease in hepatitis. Because of the enhanced C-peptide/insulin-index our results support that in the early state of hepatitis the lower insulin figures are caused through a higher insulin clearance of the acute inflamed liver.

Topics: Acute Disease; Adult; Blood Glucose; C-Peptide; Female; Glucose Tolerance Test; Hepatitis B; Hepatitis, Viral, Human; Humans; Insulin; Male; Middle Aged; Peptides

Topics: Adolescent; Adult; Blood Glucose; C-Peptide; Female; Growth Hormone; Hepatitis, Viral, Human; Humans; Hydrocortisone; Insulin; Liver Cirrhosis, Alcoholic; Male; Middle Aged

Intravenous glucose tolerance tests were performed in 10 patients with acute virus hepatitis. The assimilation coefficient of glucose and the level of insulin and C-peptide in serum were determined before and in the course of the glucose tolerance tests. In comparison to healthy normal weight persons C-peptide concentration in patients with acute hepatitis increased twice as high whereas the pattern of insulin secretion did not differ significantly. The higher levels of C-peptide indicate an increase of the beta-cell secretion in acute hepatitis. One could suppose an increased hepatic destruction of insulin in acute hepatitis, because there is no significant difference among the insulin levels. More likely, there is a reactive increase of secretion of the beta-cell due to a reduction of insulin sensitivity and this is indicated much better by C-peptide- than insulin levels because of the longer half live of the the C-peptide molecule.

Topics: Acute Disease; C-Peptide; Glucose Tolerance Test; Hepatitis, Viral, Human; Humans; Insulin; Islets of Langerhans; Peptides

Topics: Acute Disease; C-Peptide; Hepatic Encephalopathy; Hepatitis; Hepatitis, Viral, Human; Humans; Insulin; Liver; Liver Cirrhosis; Liver Diseases; Peptides