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Abnormal glucose homeostasis and fasting intolerance in patients with congenital porto-systemic shunts
In physiological glucose homeostasis, the liver plays a crucial role in the extraction of glucose from the portal circulation and storage as glycogen to enable release through glycogenolysis upon fasting. In addition, insulin secreted by the pancreas is partly eliminated from the systemic circulatio...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10471981/ https://www.ncbi.nlm.nih.gov/pubmed/37664849 http://dx.doi.org/10.3389/fendo.2023.1190473 |
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author | van Albada, Mirjam E. Shah, Pratik Derks, Terry G. J. Fuchs, Sabine Jans, Judith J. M. McLin, Valérie van der Doef, Hubert P. J. |
author_facet | van Albada, Mirjam E. Shah, Pratik Derks, Terry G. J. Fuchs, Sabine Jans, Judith J. M. McLin, Valérie van der Doef, Hubert P. J. |
author_sort | van Albada, Mirjam E. |
collection | PubMed |
description | In physiological glucose homeostasis, the liver plays a crucial role in the extraction of glucose from the portal circulation and storage as glycogen to enable release through glycogenolysis upon fasting. In addition, insulin secreted by the pancreas is partly eliminated from the systemic circulation by hepatic first-pass. Therefore, patients with a congenital porto-systemic shunt present a unique combination of (a) postabsorptive hyperinsulinemic hypoglycaemia (HH) because of decreased insulin elimination and (b) fasting (ketotic) hypoglycaemia because of decreased glycogenolysis. Patients with porto-systemic shunts therefore provide important insight into the role of the portal circulation and hepatic function in different phases of glucose homeostasis. |
format | Online Article Text |
id | pubmed-10471981 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-104719812023-09-02 Abnormal glucose homeostasis and fasting intolerance in patients with congenital porto-systemic shunts van Albada, Mirjam E. Shah, Pratik Derks, Terry G. J. Fuchs, Sabine Jans, Judith J. M. McLin, Valérie van der Doef, Hubert P. J. Front Endocrinol (Lausanne) Endocrinology In physiological glucose homeostasis, the liver plays a crucial role in the extraction of glucose from the portal circulation and storage as glycogen to enable release through glycogenolysis upon fasting. In addition, insulin secreted by the pancreas is partly eliminated from the systemic circulation by hepatic first-pass. Therefore, patients with a congenital porto-systemic shunt present a unique combination of (a) postabsorptive hyperinsulinemic hypoglycaemia (HH) because of decreased insulin elimination and (b) fasting (ketotic) hypoglycaemia because of decreased glycogenolysis. Patients with porto-systemic shunts therefore provide important insight into the role of the portal circulation and hepatic function in different phases of glucose homeostasis. Frontiers Media S.A. 2023-08-18 /pmc/articles/PMC10471981/ /pubmed/37664849 http://dx.doi.org/10.3389/fendo.2023.1190473 Text en Copyright © 2023 van Albada, Shah, Derks, Fuchs, Jans, McLin and van der Doef https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Endocrinology van Albada, Mirjam E. Shah, Pratik Derks, Terry G. J. Fuchs, Sabine Jans, Judith J. M. McLin, Valérie van der Doef, Hubert P. J. Abnormal glucose homeostasis and fasting intolerance in patients with congenital porto-systemic shunts |
title | Abnormal glucose homeostasis and fasting intolerance in patients with congenital porto-systemic shunts |
title_full | Abnormal glucose homeostasis and fasting intolerance in patients with congenital porto-systemic shunts |
title_fullStr | Abnormal glucose homeostasis and fasting intolerance in patients with congenital porto-systemic shunts |
title_full_unstemmed | Abnormal glucose homeostasis and fasting intolerance in patients with congenital porto-systemic shunts |
title_short | Abnormal glucose homeostasis and fasting intolerance in patients with congenital porto-systemic shunts |
title_sort | abnormal glucose homeostasis and fasting intolerance in patients with congenital porto-systemic shunts |
topic | Endocrinology |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10471981/ https://www.ncbi.nlm.nih.gov/pubmed/37664849 http://dx.doi.org/10.3389/fendo.2023.1190473 |
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