Abstract

PurposeThis single center prospective cohort study evaluated the influence of hemihepatectomy on glucose homeostasis.MethodsThe study included 30 patients undergoing hemihepatectomy. All patients underwent an oral 75 g glucose tolerance test before (baseline), 1 week and 1 month after the surgery. Plasma glucose, insulin and glucagon were measured in the OGTT samples, and the HOMA index was calculated. The fasting levels of interleukin 6 and 1β, tumor necrosis factor and adiponectin were assessed.ResultsThe fasting plasma and 120-min post-challenge mean glucose level increased during the study from 89.6 to 103.5 mg/dl (by 15.5 %) and from 136.4 to 162.2 (by 18.9 %; p = 0.51), respectively, accompanied by an increase in fasting glucagon (from 3.2 to 5.9 ng/mL; p = 0.043) and insulin (from 14.6 to 19.3 IU/mL) and by a decrease in plasma insulin at 60 min of OGTT (p = 0.34). An increase of IL-6 (p = 0.015) and TNF (from 49.7 to 53 pg/mL), and decrease of plasma APO (7658 to 5152 ng/mL) and exacerbation of insulin resistance (p = 0.007) were noted.ConclusionHemihepatectomy resulted in moderate disturbances in glucose homeostasis, in a majority of patients that was likely to be of minor clinical relevance. However, the patients might be at higher risk of developing overt diabetes following long-term survival.

Highlights

  • Liver diseases increase the risk of developing glucose intolerance [1], since hepatocytes play an important role in maintaining narrow range of the normal plasma glucose concentration

  • Hemihepatectomy resulted in moderate disturbances in glucose homeostasis, in a majority of patients that was likely to be of minor clinical relevance

  • The patients might be at higher risk of developing overt diabetes following long-term survival

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Summary

Introduction

Liver diseases increase the risk of developing glucose intolerance [1], since hepatocytes play an important role in maintaining narrow range of the normal plasma glucose concentration. An increasing number of patients with liver tumors are treated with hemihepatectomy [2], as it can provide long-term survival or sometimes cure in the majority of patients with primary and metastatic malignant tumors [3, 4]. The number of survivors has increased worldwide, and many new clinical questions regarding metabolic disorders have arisen in these patients. The effect of hemihepatectomy in humans on glucose homeostasis remains mostly unknown. The aim of this study was to assess the influence of hemihepatectomy performed due to liver tumor on glucose homeostasis in non-cirrhotic and non-diabetic patients

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