Department of Anesthesiology, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310003, China.
J Zhejiang Univ Sci B. 2011 Aug;12(8):677-82. doi: 10.1631/jzus.B1100001.
Decreased glucose tolerance and diabetes are frequently observed in advanced liver cirrhosis patients and may be related to insulin resistance. Glucose transporter-4 (GLUT4), one of the most important glucose transporters, plays a key role in the development of type 2 diabetes. In order to study the mechanism of insulin resistance in liver cirrhosis patients, we measured the insulin sensitivity index and determined the GLUT4 protein and mRNA contents of skeletal muscle by Western blotting and reverse transcription-polymerase chain reaction (RT-PCR), respectively, in normal people and liver cirrhosis patients. The results showed that the levels of glucose, insulin, and C-peptide in two liver cirrhosis groups were higher and the insulin sensitivity index lower than those of the normal control group. The sensitivity of insulin may decrease with the decline of liver function. However, the contents of GLUT4 protein and mRNA in patients with advanced liver cirrhosis were similar to those of normal controls. In conclusion, insulin resistance is observed in patients with advanced liver cirrhosis but may not be correlated with the skeletal contents of GLUT4 protein and mRNA.
葡萄糖耐量降低和糖尿病在晚期肝硬化患者中经常观察到，可能与胰岛素抵抗有关。葡萄糖转运蛋白-4（GLUT4）是最重要的葡萄糖转运蛋白之一，在 2 型糖尿病的发展中起着关键作用。为了研究肝硬化患者胰岛素抵抗的机制，我们通过 Western blot 和逆转录-聚合酶链反应（RT-PCR）分别测量了正常人及肝硬化患者的骨骼肌胰岛素敏感性指数和 GLUT4 蛋白和 mRNA 含量。结果表明，两个肝硬化组的血糖、胰岛素和 C 肽水平较高，胰岛素敏感性指数低于正常对照组。胰岛素敏感性可能随肝功能下降而降低。然而，晚期肝硬化患者的 GLUT4 蛋白和 mRNA 含量与正常对照组相似。综上所述，晚期肝硬化患者存在胰岛素抵抗，但可能与骨骼肌 GLUT4 蛋白和 mRNA 含量无关。
