Study of the status of hepatobil iary system and hepatic blood flow i n diabetes mellitus patients with metabolic syndrome

Abstract

The authors present the results of investigation of the functional state of hepatobiliary system and hepatic blood flow using the method of dynamic hepatobiliscintigraphy in patients with type 2 diabetes mellitus (DM) with metabolic syndrome (MS). 48 patients with severe and moderate forms of type 2 DM with MS at decompensation and compensation stages with degree 1 and 2-3 obesity, have been followed up. Radionuclide investigations were carried out on a scintillation tomographic gamma-camera “GKS 301 T” after intravenous administration of 1 MBq of 99mTc-meside per 1 kg of body weight. The protocol of registration of radiopharmaceutical preparation provided for recording 90 images with 60 sec exposure, as well as a cholagogue breakfast taken at minute 60 of the test. In patients with severe form of type 2 DM with MS at decompensation stage, a marked disturbance of liver excretory function, concentrating and motor function of the gallbladder has been established; half the patients showed a hypofunction of Oddi sphincter. No changes in absorptive and excretory function of the liver have been revealed, and disturbances of concentrating function of the gallbladder were less pronounced in patients with moderate form of type 2 DM with MS at compensation stage. In patients of type 2 DM with MS and degree 2-3 obesity a marked alteration of the time of cardioportal blood circulation was reported, as well as a significant decrease in arterial afflux to and venous drainage from the liver.