Pancreatic congestion in liver cirrhosis correlates with impaired insulin secretion View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2014-10-05

AUTHORS

Taira Kuroda, Masashi Hirooka, Mitsuhito Koizumi, Hironori Ochi, Yoshiko Hisano, Kenji Bando, Bunzo Matsuura, Teru Kumagi, Yoichi Hiasa

ABSTRACT

BackgroundAlthough impaired glucose tolerance is common in cirrhosis, this condition’s pathogenesis remains undefined. This study aimed to clarify pathogenesis related to the pancreas in cirrhotic patients, and to evaluate associations between insulin secretion and pancreatic congestion due to portal hypertension.MethodsPancreatic perfusion parameters were analyzed by dynamic contrast-enhanced ultrasound (CE-US) in 41 patients (20 cirrhotic, 21 non-cirrhotic; age, 67.9 ± 13.3; female, 19), and prospectively compared to delta C-peptide immunoreactivity (ΔCPR). In a separate study, a retrospective chart review with human autopsy specimens was conducted, and vessels and islets of the pancreas were analyzed in 43 patients (20 cirrhotic, 23 controls; age, 71.5 ± 11.6; female, 15).ResultsIn the CE-US study, the clinical characteristics indicative of portal hypertension (e.g., ascites and varices) had significantly higher incidences in the cirrhotic group than in the control group. Pancreatic drainage times were greater in the cirrhotic group (p < 0.0001), and had a significant negative correlation with ΔCPR (R = 0.42, p = 0.0069). In the histopathological study, the islets were enlarged in the cirrhotic group (p < 0.0001). However, the percentage of insulin-positive area per islet was decreased in the cirrhotic group (p < 0.0001), and had a significant negative correlation with the wall thickness of the pancreatic vein (R = 0.63, p < 0.0001).ConclusionsPancreatic congestion was present in cirrhotic patients. Moreover, pancreatic congestion and insulin secretion were significantly correlated. This pathogenesis could be a key factor underlying the development of hepatogenous diabetes in cirrhotic patients. More... »

PAGES

683-693

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s00535-014-1001-8

DOI

http://dx.doi.org/10.1007/s00535-014-1001-8

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1053521626

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/25283134


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42 autopsy specimens
43 characteristics
44 chart review
45 cirrhosis
46 cirrhotic group
47 cirrhotic patients
48 clinical characteristics
49 condition's pathogenesis
50 congestion
51 contrast-enhanced ultrasound
52 control group
53 correlation
54 development
55 diabetes
56 drainage time
57 dynamic contrast-enhanced ultrasound
58 factors
59 glucose tolerance
60 group
61 hepatogenous diabetes
62 high incidence
63 histopathological study
64 human autopsy specimens
65 hypertension
66 immunoreactivity
67 impaired insulin secretion
68 incidence
69 insulin secretion
70 insulin-positive area
71 islets
72 key factors
73 liver cirrhosis
74 negative correlation
75 pancreas
76 pancreatic vein
77 parameters
78 pathogenesis
79 patients
80 percentage
81 perfusion parameters
82 portal hypertension
83 retrospective chart review
84 review
85 secretion
86 separate studies
87 significant negative correlation
88 specimens
89 study
90 thickness
91 time
92 tolerance
93 ultrasound
94 vein
95 vessels
96 wall thickness
97 ΔCPR
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