Histochemical and morphological studies on adipocytes in cases of endemic hepatosplenomegaly

ABSTRACT

The peripheral actions of insulin were assessed using histochemical techniques on adipocytes in cases of endemic hepatosplenomegaly in a trial to identify the mechanism of carbohydrate intolerance in these cases. The study subjects included 15 cases of endemic hepatosplenomegaly with compensated liver [Group I], 15 cases of endemic hepatosplenomegaly with decompensated liver [Group II] and 15 age and sex-matched healthy controls. Subcutaneous adipose tissue biopsies were obtained from cases and controls for determination of glycogen content by Periodic Acid Schiff reaction [PAS], hormone-sensitive triglyceride lipase activity and for measurement of adipocyte diameter. A highly significant reduction in glycogen content was observed in Group I and II compared to controls [P < 0.001]. No significant difference was found between the three groups regarding hormone-sensitive lipase activity [P > 0.05]. Mean adipocyte diameters were significantly reduced in groups I and II compared to controls [P < 0.001]. We conclude that there is impairment in cellular carbohydrate utilization in cases with endemic hepatosplenomegaly. The metabolic abnormality responsible for this impairment does not appear to have caused a decrease in glucose utilization via the lipogenesis pathway in adipose tissue. This impairment may be due to receptor and/or postreceptor defects. Changes in membrane integrity of adipocytes in the present study supports this hypothesis: