Enlargement of Islets of Langerhans in Patients with Cirrhosis of the Liver

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In patients with cirrhosis of the liver (LC), it is known that glucose intolerance [29, 30] and pancreatic change related to portal hypertension [31] occur clinically. Pathologically, there are pancreatic fibrosis [32] and enlargements of islets [33, 34] (fig. 3). However, the relationship between glucose intolerance and the enlarged islets is not known. In 17 LC patients including any types/causes, an area of the islets was statistically enlarged in 14, compared with that of controls as shown in table 4. Such findings were previously

The Area Pancreatic Islets

Fig. 2. Islet changes in post-gastrectomy patients. a Hyaline replacement in an islet of Langerhans. HE. X200 (From [10] with permission). b Amyloid with nonbranching, randomly distributed 100- to 120-Â thick fibrils in the islets of Langerhans. Uranyl acetate-lead nitrate. X72,000. c Amorphous amyloid deposits were strongly immunostained with anti-amylin. X320.

Fig. 2. Islet changes in post-gastrectomy patients. a Hyaline replacement in an islet of Langerhans. HE. X200 (From [10] with permission). b Amyloid with nonbranching, randomly distributed 100- to 120-Â thick fibrils in the islets of Langerhans. Uranyl acetate-lead nitrate. X72,000. c Amorphous amyloid deposits were strongly immunostained with anti-amylin. X320.

Fig. 3. The islet of Langerhans in a patient with cirrhosis of the liver. The islet was swollen and the number of B cells were decreased (a), compared to those in the control (b). Anti-insulin immunostain. X200.

Fig. 3. The islet of Langerhans in a patient with cirrhosis of the liver. The islet was swollen and the number of B cells were decreased (a), compared to those in the control (b). Anti-insulin immunostain. X200.

Table 4. Areas of islets, B cells and acinar cells in patients with cirrhosis of liver (LC)

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Table 4. Areas of islets, B cells and acinar cells in patients with cirrhosis of liver (LC)

Case*

Blood glucose mg/dl

Islets (mean ± SD) ^m2

B cells (mean ± SD) %

Acinar cells (mean ± SD), ^m2

Control**

1,5701.0 ± 11,396.7

41.8 ± 11.3

743.8 ± 904.4

1

92

27,998.5 ± 14,821.4a

54.6 ± 7.5a

1,267.1 ± 1,257.1c

2

95

28,186.8 ± 11,451.8a

42.2 ± 6.2

894.0 ± 748.4

3

86

22,661.6 ± 14,337.0a

40.0 ± 8.8

1,466.8 ± 1,137.0c

4

90

38,585.5 ± 18,384.8a

39.7 ± 10.8

2,290.1 ± 2,124.1c

5

101

33,253.0 ± 29,000.4a

37.2 ± 10.3b

1,212.4 ± 1,622.2c

6

235

29,763.7 ± 15,304.9a

38.0 ± 8.7b

1,058.1 ± 1,031.3c

7

22,236.5 ± 23,544.6a

33.8 ± 9.1b

1,753.6 ± 1,466.8c

8

100

54,058.0 ± 34,343.2a

33.3 ± 6.9b

1,589.4 ± 1,157.9c

9

97

24,238.5 ± 10,688.3a

32.0 ± 9.5b

1,960.6 ± 1,703.6c

10

32,877.1 ± 13,508.4a

28.6 ± 7.3b

1,005.9 ± 1,121.0c

11

228

15,750.6 ± 12,111.7

26.5 ± 7.9b

1,667.4 ± 1,978.9c

12

215

55,683.6 ± 34,922.4

26.1 ± 13.5b

1,272.2 ± 1,438.4c

13

325

47,425.9 ± 30,621.3a

10.0 ± 5.7b

1,273.2 ± 1,747.1c

14

36,529.4 ± 17,233.2a

11.2 ± 4.3b

1,625.7 ± 1,252.6c

15

91

30,756.1 ± 17,301.3a

34.0 ± 16.2b

1,849.8 ± 1,555.0c

16

15,402.6 ± 6,391.2

23.7 ± 6.7b

1,876.0 ± 1,953.0c

17

20,569.0 ± 10,241.0a

19.6 ± 5.3b

1,389.1 ± 1,239.8c

*Posthepatitic LC (cases 1-13); postnecrotic LC (case 14); primary biliary cirrhosis (case 15); Alcoholic LC (cases 16 and 17).

**Mean of 4 cases asignificantly increased bsignificantly decreased csignificantly increased.

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