ArticleJournal of gastroenterology2014
Occlusion of portosystemic shunts improves hyperinsulinemia due to insulin resistance in cirrhotic patients with portal hypertension.
Article in Journal of gastroenterology, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers.
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Who cites it
19 citing papers in PubMed, 35 citations in OpenAlex.
- Navigating TIPS in the era of ageing and metabolic comorbidity: a contemporary narrative review of risk, resilience, and outcomes.Gastroenterology report · 2026Review
- Article
- [Hepatogenic diabetes: three cases report and literature review].Problemy endokrinologii · 2025Review
- Successful portosystemic shunt embolization resolves hepatic encephalopathy and enhances hepatic function and glycemic control in MASH-related cirrhosis: a case report.Clinical journal of gastroenterology · 2025Article
- The Association Between Non-Clinically Apparent Liver Fibrosis and Pulmonary Arterial Hypertension in Hispanic Patients.Cardiology research · 2023Article
- A combination of liver stiffness and international normalized ratio is an ideal prognostic predictor of portosystemic shunt occlusion in patients with portal hypertension.Journal of gastroenterology · 2023Article
- Effects of Liver Fibrosis on Islet Function in Patients with Chronic Hepatitis B Complicated with Impaired Fasting Glucose.International journal of general medicine · 2023Article
- Hepatogenous diabetes: Knowledge, evidence, and skepticism.World journal of hepatology · 2022Review
- Short-term Effects of Hepatic Arterial Buffer Responses Induced by Partial Splenic Embolization on the Hepatic Function of Patients with Cirrhosis According to the Child-Pugh Classification.Internal medicine (Tokyo, Japan) · 2021Article
- Review
- Clinical implications, diagnosis, and management of diabetes in patients with chronic liver diseases.World journal of hepatology · 2020Review
- Article
- Salvianolate Reduces Glucose Metabolism Disorders in Dimethylnitrosamine-Induced Cirrhotic Rats.Chinese journal of integrative medicine · 2018Article
- Interrelationship between insulin resistance and portal haemodynamic abnormality in cirrhosis.International journal of medical sciences · 2017Article
- Incidence of insulin resistance and diabetes in patients with portosystemic shunts without liver dysfunction.The Journal of international medical research · 2016Article
- A computer model simulating human glucose absorption and metabolism in health and metabolic disease states.F1000Research · 2016Article
- Plasma betatrophin levels in patients with liver cirrhosis.World journal of gastroenterology · 2015Article
- Pancreatic congestion in liver cirrhosis correlates with impaired insulin secretion.Journal of gastroenterology · 2015Article
- Hepatogenous Diabetes: A Primer.Journal of clinical and experimental hepatologyReview
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Authors and funding
9 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundLiver cirrhosis (LC) is often complicated by hyperinsulinemia due to insulin resistance (IR), which is considered to be closely related to shunt formation and impaired liver function. This study evaluates whether balloon-occluded retrograde transvenous obliteration (B-RTO) can affect glucose and insulin metabolism in patients with LC.
methodsTwenty-five cirrhotic patients (mean age = 69.6 years; female/male = 12/13; hepatitis C virus/alcohol/nonalcoholic steatohepatitis = 14/6/5; Child-Pugh's class A/B = 10/15) with gastric varices and/or hepatic encephalopathy caused by portosystemic shunts (PSS) due to portal hypertension (PH) underwent B-RTO at our hospital. Testing was performed before and at 1 month after the procedure.
resultsShunt occlusion resulted in a decrease in extrahepatic collateral blood flow and an increase in portal venous flow, as well as a dramatic improvement in hepatic function markers. In addition, B-RTO significantly decreased homeostasis model assessment (HOMA) of IR without a statistical decline of HOMA of β-cell function. The 75-g oral glucose tolerance test (75-OGTT) revealed that occlusion of PSS reduced both fasting immunoreactive insulin (IRI) levels and the area under the curve for IRI. However, no significant change in preprandial or postprandial plasma glucose levels was observed. Furthermore, according to the criteria of the American Diabetes Association, B-RTO led to an improved 75-OGTT profile in 58.3 % of patients who had impaired glucose tolerance or diabetes mellitus before the procedure.
conclusionsShunt occlusion improves IR-related hyperinsulinemia through increased portal venous flow, ameliorated liver function, and consequent augmented hepatic insulin clearance in cirrhotic patients with PH.
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