Hormone and metabolite profiles in alcoholic liver disease

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Abstract
Circulating hormone and metabolite profiles have been studied in ten patients with alcoholic cirrhosis, five patients with alcoholic hepatitis and/or fatty liver, and nine normal controls over a 12‐h period of meals and activity. Blood glucose was elevated throughout the day in both cirrhotic and non‐cirrhotic alcoholics (mean 12‐h glucose; controls 5.38 ± 0.16 (SEM) mmol/l; cirrhotics 6.98 ± 0.30 mmol/l, P < 0.001; non‐cirrhotics 7.18 ± 0.26 mmol/l, P < 0.001). Non‐cirrhotic alcoholics had an exaggerated insulin response to meals, whereas cirrhotic patients had hyperinsulinaemia throughout the day (mean 12‐h insulin; controls 16.3 ± 2.3 mU/l; cirrhotics 35.8 ± 6.6 mU/l, P < 0.02). Growth hormone levels were elevated only in patients with cirrhosis (mean 12‐h growth hormone, 7.06 ± 1.35 v. 0.85 ± 0.17 μg/l, P < 0.001). Serum Cortisol was persistently elevated in cirrhotics but only in the evening in non‐cirrhotic alcoholics. Lactate and pyruvate responses to meals were exaggerated in non‐cirrhotic patients whereas in cirrhotics, levels were persistently raised. Blood glycerol was elevated in all alcoholic patients whereas ketone body levels were normal. Hypertriglyceridae‐mia was observed only in non‐cirrhotic patients. No relationship between the endocrine and metabolic state was observed in either cirrhotic or non‐cirrhotic patients.