Glucose Homeostasis in Viral Hepatitis

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Abstract
Fasting hypoglycemia (plasma glucose level below 60 mg per 100 ml) was observed in eight of 15 consecutive patients with acute viral hepatitis. Plasma insulin levels were decreased 30 per cent in the eight hypoglycemic patients. The plasma glucose response to glucagon was 1/3 that of normal controls, and was not improved by a high-carbohydrate diet. In normal subjects, glucagon elicited a prompt reduction in plasma amino acid levels that was greatest for alanine and glycine. No consistent reduction in amino acid concentration after glucagon administration was observed in the hepatitis group. Liver glycogen content, determined histologically, was markedly reduced in the patients with hepatitis. Acute viral hepatitis results in serious impairment in hepatic glycogen synthesis and gluconeogenesis and frequently gives rise to fasting hypoglycemia.