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 T. Roberts, Jay Shapiro, Jesse Roth, Derek Leroith

Research output: Contribution to journalArticlepeer-review

69 Scopus citations


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


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


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