Müller M J, Böttcher J, Selberg O
Abt. Gastroenterologie und Hepatologie, Medizinische Hochschule Hannover, Germany.
Int J Obes Relat Metab Disord. 1993 Dec;17 Suppl 3:S102-6; discussion S115.
Increased energy needs, a reduced synthesis of endogenous substrates and a limited energy yield from exogenous substrates characterize the metabolic dilemma in patients with liver cirrhosis. The metabolic features observed in cirrhosis are highly variable and cannot be considered as clear-cut phenomena. They obviously differ in certain aspects from the metabolic situations known from starvation or type 2 diabetes mellitus. This is not contrary to the idea that cirrhosis may resemble certain aspects of these 'standard' situations. Cirrhosis-induced disturbances in fuel homeostasis cannot be predicted from clinical and biochemical parameters of the disease. Most of the metabolic picture is present at a very early stage of liver disease. Many metabolic features are independent of the clinical course of liver disease, suggesting that they are an early and extra-hepatic manifestation. A better understanding of the variance of cirrhosis-induced alterations in metabolism may come from characterization of the metabolic 'genotype' which adds to disease-related factors in the individual patient.
能量需求增加、内源性底物合成减少以及外源性底物能量产生受限是肝硬化患者代谢困境的特征。肝硬化中观察到的代谢特征高度可变，不能被视为明确的现象。它们在某些方面明显不同于饥饿或2型糖尿病已知的代谢情况。这与肝硬化可能类似于这些“标准”情况的某些方面的观点并不矛盾。肝硬化引起的燃料稳态紊乱无法从疾病的临床和生化参数中预测。大多数代谢情况在肝病的很早阶段就已出现。许多代谢特征与肝病的临床病程无关，表明它们是一种早期的肝外表现。更好地理解肝硬化引起的代谢改变的差异可能来自对代谢“基因型”的特征描述，这增加了个体患者中与疾病相关的因素。
