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Relationship of Insulin Resistance to Protein‐Energy Malnutrition in Patients with Alcoholic Liver Cirrhosis: Effect of Short‐Term Nutritional Support
Author(s) -
Wahl Denis G.,
Dollet JeanMarc,
Kreher Manuel,
Champigneulle Bruno,
Bigard MarcAndré,
Gaucher Pierre
Publication year - 1992
Publication title -
alcoholism: clinical and experimental research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.267
H-Index - 153
eISSN - 1530-0277
pISSN - 0145-6008
DOI - 10.1111/j.1530-0277.1992.tb01903.x
Subject(s) - insulin resistance , medicine , cirrhosis , malnutrition , transthyretin , protein–energy malnutrition , alcoholic liver disease , albumin , homeostasis , endocrinology , retinol binding protein , insulin , gastroenterology , anthropometry , retinol , vitamin
Protein‐energy malnutrition (PEM) and insulin resistance (IR) are common features of alcoholic liver cirrhosis (ALC). In order to determine a relationship between them, nutritional status and glucose homeostasis were studied in 26 patients with ALC. Nutritional status was assessed through dietary, anthropometric, and biological parameters. An IR index (M/I) was obtained from the euglycemic insulin clamp technique. M/I was significantly correlated with accurate markers of PEM (albumin, transthyretin, and retinol‐binding protein) but not with other markers of liver dysfunction. Nine patients were studied before and after nutritional support: M/I was significantly improved as were serum markers of PEM. Other markers of liver dysfunction were also significantly improved. These findings suggest that PEM could be responsible, in part, for IR in patients with ALC who are frequently malnourished. Moreover, nutritional support improved insulin sensitivity in these patients.