Objective：To investigate the effects of splenectomy and azygoportal disconnection on the glycometabolism of patients with cirrhosis and portal hypertension and their possible potential mechanisms.
Methods：Forty hospitalized non-diabetic patients with portal hypertension due to hepatitis B cirrhosis were selected. The parameters that included fasting serum insulin, insulin sensitivity index (ISI), homeostasis model assessment-insulin resistance (HOMA-IR), leptin and tumor necrosis factor-α (TNF-α) level were analyzed before and 2 weeks after splenectomy and azygoportal disconnection.
Results：The insulin level of fasting serum was decreased from (13.55±4.55) mU/L (before surgery) to (9.85±1.35) mU/L (2 weeks after surgery) (P＜0.01). The ISI was increased from -4.1±0.2 (before surgery) to -3.6±0.4 (after surgery) and the HOMA-IR was deceased from 5.5±2.1 (before surgery) to 3.3±0.6 (after surgery) (both P＜0.01). The serum level of leptin and TNF-α decreased from (14.0±9.88) μg/L and (381.6±69.5) ng/L (before surgery) to (10.68±6.04) μg/L and (325.3±48.7) ng/L (after surgery) (both P＜0.05), respectively.
Conclusions：Splenectomy and azygoportal disconnection may relieve insulin resistance and improve disorders of glucose metabolism in patients with portal hypertension due to hepatitis B cirrhosis.