Hepato‐splanchnic fluxes during exercise in patients with cirrhosis—a pilot study

<p dir="ltr">In cirrhotic patients, compromised hepatocyte function combined with disturbed hepatic blood flow could affect hepato‐splanchnic substrate and metabolite fluxes and exacerbate fatigue during exercise. Eight cirrhotic patients performed incremental cycling trials (3 × 10...

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محفوظ في:
التفاصيل البيبلوغرافية
المؤلف الرئيسي: Stefanos Volianitis (22155835) (author)
مؤلفون آخرون: Niels H. Secher (3262710) (author), Otto Clemmesen (22155838) (author), Peter Ott (4730562) (author), Henning Bay Nielsen (18792762) (author)
منشور في: 2024
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author Stefanos Volianitis (22155835)
author2 Niels H. Secher (3262710)
Otto Clemmesen (22155838)
Peter Ott (4730562)
Henning Bay Nielsen (18792762)
author2_role author
author
author
author
author_facet Stefanos Volianitis (22155835)
Niels H. Secher (3262710)
Otto Clemmesen (22155838)
Peter Ott (4730562)
Henning Bay Nielsen (18792762)
author_role author
dc.creator.none.fl_str_mv Stefanos Volianitis (22155835)
Niels H. Secher (3262710)
Otto Clemmesen (22155838)
Peter Ott (4730562)
Henning Bay Nielsen (18792762)
dc.date.none.fl_str_mv 2024-09-25T09:00:00Z
dc.identifier.none.fl_str_mv 10.14814/phy2.16162
dc.relation.none.fl_str_mv https://figshare.com/articles/journal_contribution/Hepato_splanchnic_fluxes_during_exercise_in_patients_with_cirrhosis_a_pilot_study/30024289
dc.rights.none.fl_str_mv CC BY 4.0
info:eu-repo/semantics/openAccess
dc.subject.none.fl_str_mv Biomedical and clinical sciences
Clinical sciences
Medical biochemistry and metabolomics
ammonia uptake
glucose release
lactate elimination
liver blood flow
oxygen uptake
dc.title.none.fl_str_mv Hepato‐splanchnic fluxes during exercise in patients with cirrhosis—a pilot study
dc.type.none.fl_str_mv Text
Journal contribution
info:eu-repo/semantics/publishedVersion
text
contribution to journal
description <p dir="ltr">In cirrhotic patients, compromised hepatocyte function combined with disturbed hepatic blood flow could affect hepato‐splanchnic substrate and metabolite fluxes and exacerbate fatigue during exercise. Eight cirrhotic patients performed incremental cycling trials (3 × 10 min; at light (28 [19–37] W; median with range), moderate (55 [41–69] W), and vigorous (76 [50–102] W) intensity). Heart rate increased from 68 (62–74) at rest to 95 (90–100), 114 (108–120), and 140 (134–146) beats/min (<i>P</i> < 0.05), respectively. The hepatic blood flow, as determined by constant infusion of indocyanine green with arterial and hepatic venous sampling, declined from 1.01 (0.75–1.27) to 0.69 (0.47–0.91) L/min (<i>P</i> < 0.05). Hepatic glucose output increased from 0.6 (0.5–0.7) to 1.5 (1.3–1.7) mmol/min, while arterial lactate increased from 0.8 (0.7–0.9) to 9.0 (8.1–9.9) mmol/L (<i>P</i> < 0.05) despite a rise in hepatic lactate uptake. Arterial ammonia increased in parallel to lactate from 47.3 (40.1–54.5) to 144.4 (120.5–168.3) μmol/L (<i>P</i> < 0.05), although hepatic ammonia uptake increased from 19.5 (12.4–26.6) to 69.5 (46.5–92.5) μmol/min (<i>P</i> < 0.05). Among the 14 amino acids measured, glutamate was released in the liver, while the uptake of free fatty acids decreased. During exercise at relatively low workloads, arterial lactate and ammonia levels were comparable to those seen in healthy subjects at higher workloads, while euglycemia was maintained due to sufficient hepatic glucose production. The accumulation of lactate and ammonia may contribute to exercise intolerance in patients with cirrhosis.</p><h2>Other Information</h2><p dir="ltr">Published in: Physiological Reports<br>License: <a href="http://creativecommons.org/licenses/by/4.0/" target="_blank">http://creativecommons.org/licenses/by/4.0/</a><br>See article on publisher's website: <a href="https://dx.doi.org/10.14814/phy2.16162" target="_blank">https://dx.doi.org/10.14814/phy2.16162</a></p>
eu_rights_str_mv openAccess
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identifier_str_mv 10.14814/phy2.16162
network_acronym_str Manara2
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oai_identifier_str oai:figshare.com:article/30024289
publishDate 2024
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spelling Hepato‐splanchnic fluxes during exercise in patients with cirrhosis—a pilot studyStefanos Volianitis (22155835)Niels H. Secher (3262710)Otto Clemmesen (22155838)Peter Ott (4730562)Henning Bay Nielsen (18792762)Biomedical and clinical sciencesClinical sciencesMedical biochemistry and metabolomicsammonia uptakeglucose releaselactate eliminationliver blood flowoxygen uptake<p dir="ltr">In cirrhotic patients, compromised hepatocyte function combined with disturbed hepatic blood flow could affect hepato‐splanchnic substrate and metabolite fluxes and exacerbate fatigue during exercise. Eight cirrhotic patients performed incremental cycling trials (3 × 10 min; at light (28 [19–37] W; median with range), moderate (55 [41–69] W), and vigorous (76 [50–102] W) intensity). Heart rate increased from 68 (62–74) at rest to 95 (90–100), 114 (108–120), and 140 (134–146) beats/min (<i>P</i> < 0.05), respectively. The hepatic blood flow, as determined by constant infusion of indocyanine green with arterial and hepatic venous sampling, declined from 1.01 (0.75–1.27) to 0.69 (0.47–0.91) L/min (<i>P</i> < 0.05). Hepatic glucose output increased from 0.6 (0.5–0.7) to 1.5 (1.3–1.7) mmol/min, while arterial lactate increased from 0.8 (0.7–0.9) to 9.0 (8.1–9.9) mmol/L (<i>P</i> < 0.05) despite a rise in hepatic lactate uptake. Arterial ammonia increased in parallel to lactate from 47.3 (40.1–54.5) to 144.4 (120.5–168.3) μmol/L (<i>P</i> < 0.05), although hepatic ammonia uptake increased from 19.5 (12.4–26.6) to 69.5 (46.5–92.5) μmol/min (<i>P</i> < 0.05). Among the 14 amino acids measured, glutamate was released in the liver, while the uptake of free fatty acids decreased. During exercise at relatively low workloads, arterial lactate and ammonia levels were comparable to those seen in healthy subjects at higher workloads, while euglycemia was maintained due to sufficient hepatic glucose production. The accumulation of lactate and ammonia may contribute to exercise intolerance in patients with cirrhosis.</p><h2>Other Information</h2><p dir="ltr">Published in: Physiological Reports<br>License: <a href="http://creativecommons.org/licenses/by/4.0/" target="_blank">http://creativecommons.org/licenses/by/4.0/</a><br>See article on publisher's website: <a href="https://dx.doi.org/10.14814/phy2.16162" target="_blank">https://dx.doi.org/10.14814/phy2.16162</a></p>2024-09-25T09:00:00ZTextJournal contributioninfo:eu-repo/semantics/publishedVersiontextcontribution to journal10.14814/phy2.16162https://figshare.com/articles/journal_contribution/Hepato_splanchnic_fluxes_during_exercise_in_patients_with_cirrhosis_a_pilot_study/30024289CC BY 4.0info:eu-repo/semantics/openAccessoai:figshare.com:article/300242892024-09-25T09:00:00Z
spellingShingle Hepato‐splanchnic fluxes during exercise in patients with cirrhosis—a pilot study
Stefanos Volianitis (22155835)
Biomedical and clinical sciences
Clinical sciences
Medical biochemistry and metabolomics
ammonia uptake
glucose release
lactate elimination
liver blood flow
oxygen uptake
status_str publishedVersion
title Hepato‐splanchnic fluxes during exercise in patients with cirrhosis—a pilot study
title_full Hepato‐splanchnic fluxes during exercise in patients with cirrhosis—a pilot study
title_fullStr Hepato‐splanchnic fluxes during exercise in patients with cirrhosis—a pilot study
title_full_unstemmed Hepato‐splanchnic fluxes during exercise in patients with cirrhosis—a pilot study
title_short Hepato‐splanchnic fluxes during exercise in patients with cirrhosis—a pilot study
title_sort Hepato‐splanchnic fluxes during exercise in patients with cirrhosis—a pilot study
topic Biomedical and clinical sciences
Clinical sciences
Medical biochemistry and metabolomics
ammonia uptake
glucose release
lactate elimination
liver blood flow
oxygen uptake