Glucose utilization in a patient with hepatoma and hypoglycemia: Assessment by a positron emission tomography

Richard C. Eastman, Richard E. Carson, David G. Orloff, Craig S. Cochran, James F. Perdue, Matthew M. Rechler, Fabienne Lanau, Charles Roberts, Jay Shapiro, Jesse Roth, Derek Leroith

Research output: Contribution to journalArticle

58 Citations (Scopus)

Abstract

Tumor glucose use in patients with non-islet-cell tumors has been difficult to measure, particularly in hepatoma, because of hepatic involvement by neoplasm. We studied a patient with nonhepatic recurrence of hepatoma after successful liver transplantation. Tumor tissue contained messenger RN A for insulin-like growth factor-II (IGF-II), and circulating high molecular weight components and E-peptide of IGF-II were increased. Glucose use measured by isotope dilution with [3-3H]glucose was 7.94 mg/kg fat-free mass per min, and splanchnic glucose production was 0.93 mg/kg fat-free mass per min. Glucose uptake and glucose model parameters were independently measured in tissues by positron emission tomography with 18F-fluoro-2-deoxy-D-glucose. Glucose uptake by heart muscle, liver, skeletal muscle, and neoplasm accounted for 0.8, 14, 44, and 15% of total glucose use, respectively. Model parameters in liver and neoplasm were not significantly different, and glucose transport and phosphorylation were twofold and fourfold greater than in muscle. This suggests that circulating IGF-II-like proteins are partial insulin agonists, and that hypoglycemia in hepatoma with IGF-II production is predominantly due to glucose uptake by skeletal muscle and suppression of glucose production.

Original languageEnglish (US)
Pages (from-to)1958-1963
Number of pages6
JournalJournal of Clinical Investigation
Volume89
Issue number6
StatePublished - 1992
Externally publishedYes

Fingerprint

Hypoglycemia
Positron-Emission Tomography
Hepatocellular Carcinoma
Glucose
Insulin-Like Growth Factor II
Liver Neoplasms
Skeletal Muscle
Muscle Neoplasms
Fats
Neoplasms
Viscera
Deoxyglucose
Isotopes
Liver Transplantation
Myocardium
Molecular Weight
Phosphorylation
Insulin
Recurrence
Muscles

Keywords

  • Hepatoma
  • Hypoglycemia
  • Insulin-like growth factor-II
  • Non-islet-cell tumor
  • Positron emission tomography

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Eastman, R. C., Carson, R. E., Orloff, D. G., Cochran, C. S., Perdue, J. F., Rechler, M. M., ... Leroith, D. (1992). Glucose utilization in a patient with hepatoma and hypoglycemia: Assessment by a positron emission tomography. Journal of Clinical Investigation, 89(6), 1958-1963.

Glucose utilization in a patient with hepatoma and hypoglycemia : Assessment by a positron emission tomography. / Eastman, Richard C.; Carson, Richard E.; Orloff, David G.; Cochran, Craig S.; Perdue, James F.; Rechler, Matthew M.; Lanau, Fabienne; Roberts, Charles; Shapiro, Jay; Roth, Jesse; Leroith, Derek.

In: Journal of Clinical Investigation, Vol. 89, No. 6, 1992, p. 1958-1963.

Research output: Contribution to journalArticle

Eastman, RC, Carson, RE, Orloff, DG, Cochran, CS, Perdue, JF, Rechler, MM, Lanau, F, Roberts, C, Shapiro, J, Roth, J & Leroith, D 1992, 'Glucose utilization in a patient with hepatoma and hypoglycemia: Assessment by a positron emission tomography', Journal of Clinical Investigation, vol. 89, no. 6, pp. 1958-1963.
Eastman RC, Carson RE, Orloff DG, Cochran CS, Perdue JF, Rechler MM et al. Glucose utilization in a patient with hepatoma and hypoglycemia: Assessment by a positron emission tomography. Journal of Clinical Investigation. 1992;89(6):1958-1963.
Eastman, Richard C. ; Carson, Richard E. ; Orloff, David G. ; Cochran, Craig S. ; Perdue, James F. ; Rechler, Matthew M. ; Lanau, Fabienne ; Roberts, Charles ; Shapiro, Jay ; Roth, Jesse ; Leroith, Derek. / Glucose utilization in a patient with hepatoma and hypoglycemia : Assessment by a positron emission tomography. In: Journal of Clinical Investigation. 1992 ; Vol. 89, No. 6. pp. 1958-1963.
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abstract = "Tumor glucose use in patients with non-islet-cell tumors has been difficult to measure, particularly in hepatoma, because of hepatic involvement by neoplasm. We studied a patient with nonhepatic recurrence of hepatoma after successful liver transplantation. Tumor tissue contained messenger RN A for insulin-like growth factor-II (IGF-II), and circulating high molecular weight components and E-peptide of IGF-II were increased. Glucose use measured by isotope dilution with [3-3H]glucose was 7.94 mg/kg fat-free mass per min, and splanchnic glucose production was 0.93 mg/kg fat-free mass per min. Glucose uptake and glucose model parameters were independently measured in tissues by positron emission tomography with 18F-fluoro-2-deoxy-D-glucose. Glucose uptake by heart muscle, liver, skeletal muscle, and neoplasm accounted for 0.8, 14, 44, and 15{\%} of total glucose use, respectively. Model parameters in liver and neoplasm were not significantly different, and glucose transport and phosphorylation were twofold and fourfold greater than in muscle. This suggests that circulating IGF-II-like proteins are partial insulin agonists, and that hypoglycemia in hepatoma with IGF-II production is predominantly due to glucose uptake by skeletal muscle and suppression of glucose production.",
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AB - Tumor glucose use in patients with non-islet-cell tumors has been difficult to measure, particularly in hepatoma, because of hepatic involvement by neoplasm. We studied a patient with nonhepatic recurrence of hepatoma after successful liver transplantation. Tumor tissue contained messenger RN A for insulin-like growth factor-II (IGF-II), and circulating high molecular weight components and E-peptide of IGF-II were increased. Glucose use measured by isotope dilution with [3-3H]glucose was 7.94 mg/kg fat-free mass per min, and splanchnic glucose production was 0.93 mg/kg fat-free mass per min. Glucose uptake and glucose model parameters were independently measured in tissues by positron emission tomography with 18F-fluoro-2-deoxy-D-glucose. Glucose uptake by heart muscle, liver, skeletal muscle, and neoplasm accounted for 0.8, 14, 44, and 15% of total glucose use, respectively. Model parameters in liver and neoplasm were not significantly different, and glucose transport and phosphorylation were twofold and fourfold greater than in muscle. This suggests that circulating IGF-II-like proteins are partial insulin agonists, and that hypoglycemia in hepatoma with IGF-II production is predominantly due to glucose uptake by skeletal muscle and suppression of glucose production.

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