Glucose intolerance after massive liver resection in man and other mammals

Abstract

The relationship between changes in glucose tolerance and in mitochondrial phosphorylative activity was studied after massive liver resection. In rabbits twenty-four hours after hepatectomy, when the phosphorylative activity in the mitochondria of the remnant liver was enhanced maximally, the blood glucose level did not increase significantly after glucose administration. Fortyeight hours after hepatectomy, when the phosphorylative activity decreased to a submaximal level, the blood glucose level increased gradually but without a return toward normal. About six weeks after partial hepatectomy, mitochondrial function returned gradually to normal levels and the glucose tolerance test results returned to within normal limits. Considering the previous report that an enhancement of mitochondrial phosphorylative activity is required for a later increase in nuclear DNA synthesis, it was suggested that the plateau pattern, with hypoglycemia, and the gradual increase, with a prolonged return toward normal, in the glucose tolerance test are indicative of marked enhancement of mitochondrial phosphorylative activity preceding an increase in nuclear DNA synthesis. The changes in the glucose tolerance test results in hepatectomized rabbits also were observed in rats and in man; however, they were more rapid in rats and slower in man. From these results it was suggested that the glucose tolerance test is very useful in the evaluation of the stage of regeneration in the liver remnant after massive liver resection.