, Volume 35, Issue 3, pp 467–476

Fasting and postprandial plasma ghrelin levels are decreased in patients with liver failure previous to liver transplantation

  • Maria Teresa Diz-Lois
  • Jesús Garcia-Buela
  • Francisco Suarez
  • Susana Sangiao-Alvarellos
  • Ovidio Vidal
  • Fernando Cordido
Original Paper


Anorexia is a problem of paramount importance in patients with advanced liver failure. Ghrelin has important actions on feeding and weight homeostasis. Concentrations of ghrelin are controversial in liver cirrhosis. Our aim was to study fasting ghrelin and their response to an oral glucose tolerance test (OGTT) in liver failure patients and normal subjects. Methods We included 16 patients with severe liver failure prior to liver transplantation. As a control group we included 10 age- and BMI-matched healthy subjects. After an overnight fast, 75 g of oral glucose were administered; glucose, insulin, and ghrelin were obtained at baseline and at times 30, 60, 90, and 120 min, respectively. Results Fasting ghrelin (median and range) were statistically significantly lower for patients compared to the controls, 527 (377–971) pg/ml vs. 643 (523–2163) pg/ml, P = 0.045, for patients and controls, respectively. The area under the curve for total ghrelin post-OGTT were lower in end-stage liver failure patients than in the control group, 58815 (44730–87420) pg/ml min vs. 76560 (56160–206385) pg/ml min, for patients and controls, respectively, P = 0.027. Conclusions Ghrelin levels are significantly decreased both fasting and post-OGTT in patients with liver failure candidates for transplantation. Decreased ghrelin levels could contribute to anorexia in patients with cirrhosis.


Ghrelin Liver failure Oral glucose 


  1. 1.
    O. Selberg, J. Böttcher, G. Tusch, R. Pichlmayr, E. Henkel, M.J. Muller, Identification of high- and low-risk patients before liver transplantation: a prospective cohort study of nutritional and metabolic parameters in 150 patients. Hepatology 25, 652–657 (1997)CrossRefPubMedGoogle Scholar
  2. 2.
    C. Matos, M.K. Porayko, N. Francisco-Ziller, S. DiCecco, Nutrition and chronic liver disease. J. Clin. Gastroenterol. 35, 391–397 (2002)CrossRefPubMedGoogle Scholar
  3. 3.
    H.I.M. Davidson, R. Richardson, D. Sutherland, O.J. Garden, Macronutrient preference, dietary intake, and substrate oxidation among stable cirrhotic patients. Hepatology 29, 1380–1386 (1999)CrossRefPubMedGoogle Scholar
  4. 4.
    G. Marchesini, G. Bianchi, P. Lucidi, N. Villanova, M. Zoli, P. De Feo, Plasma ghrelin concentrations, food intake, and anorexia in liver failure. J. Clin. Endocrinol. Metab. 89, 2136–2141 (2004)CrossRefPubMedGoogle Scholar
  5. 5.
    J. Ockenga, S.C. Bischoff, H.L. Tillmann, K. Rifai, A. Widjaja, K.H. Böker, M.P. Manns, G. Brabant, Elevated bound leptin correlates with energy expenditure in cirrhotics. Gastroenterology 119, 1656–1662 (2001)CrossRefGoogle Scholar
  6. 6.
    A.M. Madden, M.Y. Morgan, Resting energy expenditure should be measured in patients with cirrhosis, not predicted. Hepatology 30, 655–664 (1999)CrossRefPubMedGoogle Scholar
  7. 7.
    A. Laviano, C. Cangiano, I. Preziosa, O. Riggio, L. Conversano, A. Cascino, S. Ariemma, F. Rossi Fanelli, Plasma tryptophan levels and anorexia in liver cirrhosis. Int. J. Eat. Disord. 21, 181–186 (1997)CrossRefPubMedGoogle Scholar
  8. 8.
    H.U. Lautz, O. Selberg, J. Korber, M. Burger, M.J. Muller, Forms of malnutrition in patients with liver cirrhosis. Clin. Invest. 70, 178–186 (1992)CrossRefGoogle Scholar
  9. 9.
    M. Merli, O. Riggio, L. Dally, Does malnutrition affect survival in cirrhosis? Policentrica Italiana Nutrizione Cirrosi (PINC). Hepatology 23, 1041–1046 (1996)CrossRefPubMedGoogle Scholar
  10. 10.
    M. Kojima, H. Hosoda, Y. Date, M. Nakazato, H. Matsuo, K. Kangawa, Ghrelin is a growth hormone-releasing acylated peptide from stomach. Nature 402, 656–658 (1999)CrossRefPubMedGoogle Scholar
  11. 11.
    F. Cordido, A. Peñalva, C. Dieguez, F. Casanueva, Massive growth hormone (GH) discharge in obese subjects after the combined administration of Growth Hormone releasing hormone and GHRP-6: evidence for a marked somatotroph secretory capability in obesity. J. Clin. Endocrinol. Metab. 76, 819–823 (1993)CrossRefPubMedGoogle Scholar
  12. 12.
    P. Alvarez, L. Isidro, J. Garcia-Buela, J. Leal-Cerro, F. Broglio, F. Tassone, E. Ghigo, C. Dieguez, F.F. Casanueva, F. Cordido, Marked GH secretion after ghrelin alone or combined with GH-releasing hormone (GHRH) in obese patients. Clin. Endocrinol. 61, 250–255 (2004)CrossRefGoogle Scholar
  13. 13.
    A.J. van der Lely, M. Tschop, M.L. Heiman, E. Ghigo, Biological, physiological, pathophysiological, and pharmacological aspects of ghrelin. Endocr. Rev. 25, 426–457 (2004)CrossRefPubMedGoogle Scholar
  14. 14.
    M. Tschop, D.L. Smiley, M.L. Heiman, Ghrelin induces adiposity in rodents. Nature 407, 908–909 (2000)CrossRefPubMedGoogle Scholar
  15. 15.
    M. Nakazato, N. Murakami, Y. Date, M. Kojima, H. Matsuo, K. Kangawa, S. Matsukura, A role for ghrelin in the central regulation of feeding. Nature 409, 194–198 (2001)CrossRefPubMedGoogle Scholar
  16. 16.
    Y. Shuto, T. Shibasaki, A. Otagiri, H. Kuriyama, H. Ohata, H. Tamura, J. Kamegai, H. Sugihara, S. Oikawa, I. Wakabayashi, Hypothalamic growth hormone secretagogue receptor regulates growth hormone secretion, feeding and adiposity. J. Clin. Invest. 109, 1429–1436 (2002)PubMedGoogle Scholar
  17. 17.
    A.M. Wren, L.J. Seal, M.A. Cohen, A.E. Brynes, G.S. Frost, K.G. Murphy, Ghrelin enhances appetite and increases food intake in humans. J. Clin. Endocrinol. Metab. 86, 5992–5998 (2001)CrossRefPubMedGoogle Scholar
  18. 18.
    D.E. Cummings, K. Clement, J.Q. Purnell, C. Vaisse, K.E. Foster, R.S. Frayo, M.W. Schwartz, A. Basdevant, D.S. Weigle, Elevated plasma ghrelin levels in Prader-Willi syndrome. Nat. Med. 8, 643–644 (2002)CrossRefPubMedGoogle Scholar
  19. 19.
    D.E. Cummings, D.S. Weigle, R.S. Frayo, P.A. Breen, M.K. Ma, E.P. Dellinger, J.Q. Purnell, Plasma ghrelin levels after diet-induced weight loss or gastric bypass surgery. N. Engl. J. Med. 346, 1623–1630 (2002)CrossRefPubMedGoogle Scholar
  20. 20.
    M. Tschop, C. Weyer, P.A. Tataranni, V. Devanarayan, E. Ravussin, M.L. Heiman, Circulating ghrelin are decreased in human obesity. Diabetes 50, 707–709 (2001)CrossRefPubMedGoogle Scholar
  21. 21.
    A.M. Haqq, I.S. O′Farooqi, S. Rahilly, D.D. Stadler, R.G. Rosenfeld, K.L. Prat, S.H. LaFranchi, J.Q. Purnell, Serum ghrelin levels are inversely correlated with body mass index, age, and insulin concentrations in normal children and are markedly increased in Prader-Willi syndrome. J. Clin. Endocrinol. Metab. 88, 174–178 (2003)CrossRefPubMedGoogle Scholar
  22. 22.
    G. Muccioli, M. Tschop, M. Papotti, R. Deghenghi, M. Heiman, E. Ghigo, Neuroendocrine and peripheral activities of ghrelin: implications in metabolism and obesity. Eur. J. Pharmacol. 440, 235–254 (2002)CrossRefPubMedGoogle Scholar
  23. 23.
    B. Otto, U. Cuntz, E. Fruehauf, R. Wawarta, C. Folwaczny, R.L. Riepl, M.L. Heiman, P. Lehnert, M. Fichter, M. Tschöp, Weight gain decreases elevated plasma ghrelin concentrations of patients with anorexia nervosa. Eur. J. Endocrinol. 145, 669–673 (2001)CrossRefPubMedGoogle Scholar
  24. 24.
    O. Ukkola, Ghrelin and insulin metabolism. Eur. J. Clin. Invest. 33, 183–185 (2003)CrossRefPubMedGoogle Scholar
  25. 25.
    A. Asakawa, A. Inui, T. Kaga, G. Katsuura, M. Fujimiya, M.A. Fujino, M. Kasuga, Antagonism of ghrelin receptor reduces food intake and body weight gain in mice. Gut 52, 947–952 (2003)CrossRefPubMedGoogle Scholar
  26. 26.
    T. McLaughlin, F. Abbasi, C. Lamendola, R.S. Frayo, D.E. Cummings, Plasma ghrelin concentrations are decreased in insulin-resistant obese adults relative to equally obese insulin-sensitive controls. J. Clin. Endocrinol. Metab. 89, 1630–1635 (2004)CrossRefPubMedGoogle Scholar
  27. 27.
    T. Shiiya, M. Nakazato, M. Mizuta, Y. Date, M.S. Mondal, M. Tanaka, S. Nozoe, H. Hosoda, K. Kangawa, S. Matsukura, Plasma ghrelin levels in lean and obese humans and the effect of glucose on ghrelin secretion. J. Clin. Endocrinol. Metab. 87, 240–244 (2002)CrossRefPubMedGoogle Scholar
  28. 28.
    D.E. Cummings, J.Q. Purnell, R.S. Frayo, K. Schmidova, B.E. Wisse, D.S. Weigle, A preprandial rise in plasma ghrelin levels suggests a role in meal initiation in humans. Diabetes 50, 1714–1719 (2001)CrossRefPubMedGoogle Scholar
  29. 29.
    M. Kojima, K. Kangawa, Ghrelin: structure and function. Physiol. Rev. 85, 495–522 (2005)CrossRefPubMedGoogle Scholar
  30. 30.
    M. Hotta, R. Ohwada, H. Katakami, T. Shibasaki, N. Hizuka, K. Takano, Plasma levels of intact and degraded ghrelin and their responses to glucose infusion in anorexia nervosa. J. Clin. Endocrinol. Metab. 89, 571–5707 (2004)CrossRefGoogle Scholar
  31. 31.
    E. Kalaitzakis, I. Bosaeus, L. Ohman, E. Björnsson, Altered postprandial glucose, insulin, leptin, and ghrelin in liver cirrhosis: correlations with energy intake and resting energy expenditure. Am. J. Clin. Nutr. 85, 808–815 (2007)PubMedGoogle Scholar
  32. 32.
    H. Ataseven, I.H. Bahcecioglu, N. Kuzu, M. Yalniz, S. Celebi, A. Erensoy, B. Ustundag, The levels of ghrelin, leptin, TNF-alpha, and IL-6 in liver cirrhosis and hepatocellular carcinoma due to HBV and HDV infection. Mediators Inflamm. 2006, 78380–78385 (2006)CrossRefPubMedGoogle Scholar
  33. 33.
    H. Takahashi, A. Kato, K. Onodera, K. Suzuki, Fasting plasma ghrelin levels reflect malnutrition state in patients with liver cirrhosis. Hepatol. Res. 34, 117–123 (2006)CrossRefPubMedGoogle Scholar
  34. 34.
    M. Breidert, T.F. Zimmermann, R. Schneider, G. Ehninger, G. Brabant, Ghrelin/Leptin-imbalance in patients with primary biliary cirrhosis. Exp. Clin. Endocrinol. Diabetes 112, 123–126 (2004)CrossRefPubMedGoogle Scholar
  35. 35.
    F. Tacke, G. Brabant, E. Kruck, R. Horn, P. Schöffski, H. Hecker, M.P. Manns, C. Trautwein, Ghrelin in chronic liver disease. J. Hepatol. 38, 447–454 (2003)CrossRefPubMedGoogle Scholar
  36. 36.
    M. Granado, A.I. Martín, M. López-Menduiña, A. López-Calderón, M.A. Villanúa, GH-releasing peptide-2 administration prevents liver inflammatory response in endotoxemia. Am. J. Physiol. Endocrinol. Metab. 294, E131–E141 (2008)CrossRefPubMedGoogle Scholar
  37. 37.
    S.O. Işeri, G. Sener, B. Saglam, F. Ercan, N. Gedik, B.C. Yeğen, Ghrelin alleviates biliary obstruction-induced chronic hepatic injury in rats. Regul. Pept. 146, 73–79 (2008)CrossRefPubMedGoogle Scholar
  38. 38.
    O. Kasımay, S.O. Işeri, A. Barlas, D. Bangir, C. Yeğen, S. Arbak, B.C. Yeğen, Ghrelin ameliorates pancreaticobiliary inflammation and associated remote organ injury in rats. Hepatol. Res. 36, 11–19 (2006)CrossRefPubMedGoogle Scholar
  39. 39.
    H. Hosoda, M. Kojima, T. Mizushima, S. Shimizu, K. Kangawa, Structural divergence of human ghrelin. Identification of multiple ghrelin-derived molecules produced by post-translational processing. J. Biol. Chem. 278, 64–70 (2003)CrossRefPubMedGoogle Scholar
  40. 40.
    X. Zhu, Y. Cao, K. Voodg, D.F. Steiner, On the processing of proghrelin to ghrelin. J. Biol. Chem. 281, 38867–38870 (2006)CrossRefPubMedGoogle Scholar
  41. 41.
    M.A. Bednarek, S.D. Feighner, S.S. Pong, K.K. McKee, D.L. Hreniuk, M.V. Silva, V.A. Warren, A.D. Howard, L.H. Van Der Ploeg, J.V. Heck, Structure-function studies on the new growth hormone-releasing peptide, ghrelin: minimal sequence of ghrelin necessary for activation of growth hormone secretagogue receptor 1a. J. Med. Chem. 43, 4370–4376 (2000)CrossRefPubMedGoogle Scholar
  42. 42.
    P. Cassoni, M. Papotti, C. Ghe, F. Catapano, A. Sapino, A. Graziani, R. Deghenghi, T. Reissmann, E. Ghigo, G. Muccioli, Identification, characterization, and biological activity of specific receptors for natural (ghrelin) and synthetic growth hormone secretagogues and analogs in human breast carcinomas and cell lines. J. Clin. Endocrinol. Metab. 86, 1738–1745 (2001)CrossRefPubMedGoogle Scholar
  43. 43.
    I. Bedendi, G. Alloatti, A. Marcantoni, D. Malan, F. Catapano, C. Ghe, R. Deghenghi, E. Ghigo, G. Muccioli, Cardiac effects of ghrelin and its endogenous derivatives des-octanoyl ghrelin and des-Gln14-ghrelin. Eur. J. Pharmacol. 476, 87–95 (2003)CrossRefPubMedGoogle Scholar
  44. 44.
    N.M. Thompson, D.A. Gill, R. Davies, N. Loveridge, P.A. Houston, I.C. Robinson, T. Wells, Ghrelin and des-octanoyl ghrelin promote adipogenesis directly in vivo by a mechanism independent of the type 1a growth hormone secretagogue receptor. Endocrinology 145, 234–242 (2004)CrossRefPubMedGoogle Scholar
  45. 45.
    K. Toshinai, H. Yamaguchi, Y.X. Sun, R.G. Smith, A. Yamanaka, T. Sakurai, Y. Date, M.S. Mondal, T. Shimbara, T. Kawagoe, N. Murakami, M. Miyazato, K. Kangawa, M. Nakazato, Des-acyl ghrelin induces food intake by a mechanism independent of the growth hormone secretagogue receptor. Endocrinology 147, 2306–2314 (2006)CrossRefPubMedGoogle Scholar
  46. 46.
    C. Gauna, P.J. Delhanty, M.O. van Aken, J.A. Janssen, A.P. Themmen, L.J. Hofland, M. Culler, F. Broglio, E. Ghigo, A.J. van der Lely, Unacylated ghrelin is active on the INS-1E rat insulinoma cell line independently of the growth hormone secretagogue receptor type 1a and the corticotropin releasing factor 2 receptor. Mol. Cell. Endocrinol. 251, 103–111 (2006)CrossRefPubMedGoogle Scholar
  47. 47.
    C. Gauna, F.M. Meyler, J.A. Janssen, P.J.D. Delhanty, T. Abribat, P. van Koetsveld, L.J. Hofland, F. Broglio, E. Ghigo, A.J. van der Lely, Administration of acylated ghrelin reduces insulin sensitivity, whereas the combination of acylated plus unacylated ghrelin strongly improves insulin sensitivity. J. Clin. Endocrinol. Metab. 89, 5035–5042 (2004)CrossRefPubMedGoogle Scholar
  48. 48.
    M. Tschöp, R. Wawarta, R.L. Riepl, S. Friedrich, M. Bidlingmaier, R. Landgraf, C. Folwaczny, Post-prandial decrease of circulating human ghrelin levels. J. Endocrinol. Invest. 24, RC19–RC21 (2001)PubMedGoogle Scholar
  49. 49.
    K.E. Foster-Schubert, J. Overduin, C.E. Prudom, J. Liu, H.S. Callahan, B.D. Gaylinn, M.O. Thorner, D.E. Cummings, Acyl and total ghrelin are suppressed strongly by ingested proteins, weakly by lipids, and biphasically by carbohydrates. J. Clin. Endocrinol. Metab. 93, 1971–1979 (2008)CrossRefPubMedGoogle Scholar
  50. 50.
    J. Liu, C.E. Prudom, R. Nass, S.S. Pezzoli, M.C. Oliveri, M.L. Johnson, P. Veldhuis, D.A. Gordon, A.D. Howard, D.R. Witcher, H.M. Geysen, B.D. Gaylinn, M.O. Thorner, Novel ghrelin assays provide evidence for independent regulation of ghrelin acylation and secretion in healthy young men. J. Clin. Endocrinol. Metab. 93, 1980–1987 (2008)CrossRefPubMedGoogle Scholar
  51. 51.
    G. Marchesini, U. Pagotto, E. Bugianesi, R. De Iasio, R. Manini, E. Vanni, R. Pasquali, N. Melchionda, M. Rizzetto, Low ghrelin concentrations in nonalcoholic fatty liver disease are related to insulin resistance. J. Clin. Endocrinol. Metab. 88, 5674–5679 (2003)CrossRefPubMedGoogle Scholar
  52. 52.
    G. Murdolo, P. Lucidi, C. Di Loreto, N. Parlanti, A. De Cicco, C. Fatone, C.G. Fanelli, G.B. Bolli, F. Santeusanio, P. De Feo, Insulin is required for prandial ghrelin suppression in humans. Diabetes 52, 2923–2927 (2003)CrossRefPubMedGoogle Scholar
  53. 53.
    D.E. Flanagan, M.L. Evans, T.P. Monsod, F. Rife, R.A. Heptulla, W.V. Tamborlane, R.S. Sherwin, The influence of insulin on circulating ghrelin. Am. J. Physiol. Endocrinol. Metab. 284, E313–E316 (2003)PubMedGoogle Scholar
  54. 54.
    W.A.M. Blom, A. Stafleu, C. de Graaf, F.J. Kok, G. Schaafsma, H.F. Hendriks, Ghrelin response to carbohydrate-enriched breakfast is related to insulin. Am. J. Clin. Nutr. 81, 367–375 (2005)PubMedGoogle Scholar
  55. 55.
    A. Caixas, C. Bashore, W. Nash, X. Pi-Sunyer, B. Laferrere, Insulin, unlike food intake, does not suppress ghrelin in human subjects. J. Clin. Endocrinol. Metab. 87, 1902–1905 (2002)CrossRefPubMedGoogle Scholar
  56. 56.
    G. Schaller, A. Schmidt, J. Pleiner, W. Woloszczuk, M. Woltz, A. Luger, Plasma ghrelin concentrations are not regulated by glucose or insulin: a double-blind, placebo-controlled crossover clamp study. Diabetes 5, 16–20 (2003)CrossRefGoogle Scholar
  57. 57.
    R. Nass, L.S. Farhy, J. Liu, C.E. Prudom, M.L. Johnson, P. Veldhuis, S.S. Pezzoli, M.C. Oliveri, B.D. Gaylinn, H.M. Geysen, M.O. Thorner, Evidence for acyl-ghrelin modulation of growth hormone release in the fed state. J. Clin. Endocrinol. Metab. 93, 1988–1994 (2008)CrossRefPubMedGoogle Scholar
  58. 58.
    F.M. Van der Toorn, J.A. Janssen, W.W. de Herder, F. Broglio, E. Ghigo, A.J. van der Lely, Central ghrelin production does not substantially contribute to systemic ghrelin concentration: a study inn two subjects with active acromegaly. Eur. J. Endocrinol. 147, 195–199 (2002)CrossRefPubMedGoogle Scholar
  59. 59.
    A.L. Barkan, E.V. Dimaraki, S.K. Jessup, K.V. Symons, M. Ermolenko, C.A. Jaffe, Ghrelin secretion in humans is sexually dimorphic, suppressed by somatostatin, and not affected by the ambient growth hormone levels. J. Clin. Endocrinol. Metab. 88, 2180–2184 (2003)CrossRefPubMedGoogle Scholar
  60. 60.
    Z. Jarkovska, M. Rosicka, J. Marek, V. Hana, V. Weiss, V. Justova, Z. Lacinová, M. Haluzík, M. Krsek, Plasma levels of total and active ghrelin in acromegaly and growth hormone deficiency. Physiol. Res. 55, 175–181 (2006)PubMedGoogle Scholar
  61. 61.
    M.L. Isidro, R. Nemiña, J. Garcia-Buela, S. Sangiao-Alvarellos, F. Cordido, Effect of oral glucose on acylated and total ghrelin secretion in acromegalic patients. Neuro Endocrinol. Lett. 28, 596–603 (2007)PubMedGoogle Scholar
  62. 62.
    V. Cappiello, C. Ronchi, P.S. Mospurgo, P. Epaminonda, P. Beck-Peccoz, A. Spada, Circulating ghrelin levels in basal conditions and during glucose tolerance test in acromegalic patients. Eur. J. Endocrinol. 147, 189–194 (2002)CrossRefPubMedGoogle Scholar
  63. 63.
    P.U. Freda, C.M. Reyes, I.M. Conwell, R.E. Sundeen, S.L. Wardlaw, Serum ghrelin levels in acromegaly: effects of surgical and long-acting octreotide therapy. J. Clin. Endocrinol. Metab. 88, 2037–2044 (2003)CrossRefPubMedGoogle Scholar
  64. 64.
    J. Kozakowski, M. Rabijewski, W. Zgliczynski, Decreased in serum ghrelin levels in patients with acromegaly normalize after successful surgical treatment. Endokrynol. Pol. 56, 862–870 (2005)PubMedGoogle Scholar
  65. 65.
    E.T. Vestergaard, R. Dall, K.H. Lange, M. Kjaer, J.S. Christiansen, J.O. Jorgensen, The ghrelin response to exercise before and after growth hormone administration. J. Clin. Endocrinol. Metab. 92, 297–303 (2007)CrossRefPubMedGoogle Scholar
  66. 66.
    H.J. Kim, L. Sangyeoup, T.W. Kim, H.H. Kim, T.Y. Jeon, Y.S. Yoon, S.W. Oh, H. Kwak, J.G. Lee, Effects of exercise-induced weight loss on acylated and unacylated ghrelin in overweight children. Clin. Endocrinol. 68, 416–422 (2008)Google Scholar
  67. 67.
    M. Perez-Fontán, F. Cordido, A. Rodriguez-Carmona, J. Peteiro, R. Garcia-Naveiro, J. Garcia-Buela, Plasma ghrelin levels in patients undergoing haemodialysis and peritoneal diálysis. Nephrol. Dial. Transplant. 19, 2095–2100 (2004)CrossRefPubMedGoogle Scholar
  68. 68.
    M. Perez-Fontán, F. Cordido, A. Rodriguez-Carmona, R. Garcia-Naveiro, M.L. Isidro, P. Villaverde, J. Garcia-Buela, Acute plasma ghrelin and leptin responses to oral feeding or intraperitoneal hypertonic glucose-based dialysate in patients with chronic renal failure. Kidney Int. 2005(68), 2877–2885 (2005)CrossRefGoogle Scholar
  69. 69.
    M. Pérez-Fontán, F. Cordido, A. Rodríguez-Carmona, M. Penín, H. Díaz-Cambre, A. López-Muñiz, S. Sangiao-Alvarellos, J. García-Buela, Short-term regulation of peptide YY secretion by a mixed meal or peritoneal glucose-based dialysate in patients with chronic renal failure. Nephrol. Dial. Transplant. 23, 3696–3703 (2008)CrossRefPubMedGoogle Scholar
  70. 70.
    D.R. Matthews, J.P. Hosker, A.S. Rudenski, D.B. Naylor, D.F. Treacher, R.C. Turner, Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetología 28, 412–419 (1985)CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2009

Authors and Affiliations

  • Maria Teresa Diz-Lois
    • 1
  • Jesús Garcia-Buela
    • 4
  • Francisco Suarez
    • 1
  • Susana Sangiao-Alvarellos
    • 3
    • 5
  • Ovidio Vidal
    • 2
  • Fernando Cordido
    • 2
    • 3
    • 5
  1. 1.Department of GastroenterologyHospital A CoruñaA CoruñaSpain
  2. 2.Department of EndocrinologyHospital A CoruñaA CoruñaSpain
  3. 3.Department of InvestigationHospital A CoruñaA CoruñaSpain
  4. 4.Department of LaboratoryHospital A CoruñaA CoruñaSpain
  5. 5.Department of MedicineUniversity of A CoruñaA CoruñaSpain

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