Pancreatic Hormone Responses to Mixed Meal Test in New-onset Prediabetes/Diabetes After Non-necrotizing Acute Pancreatitis

被引:29
作者
Pendharkar, Sayali A. [1 ]
Singh, Ruma G. [1 ]
Bharmal, Sakina H. [1 ]
Drury, Marie [1 ]
Petrov, Maxim S. [1 ]
机构
[1] Univ Auckland, Sch Med, Auckland, New Zealand
关键词
acute pancreatitis; insulin secretion; insulin sensitivity; mixed meal test; new-onset diabetes; pancreatic hormones; DIABETES-MELLITUS; INSULIN-SECRETION; EXOCRINE PANCREAS; GLUCOSE; RISK; CLASSIFICATION; DISEASES;
D O I
10.1097/MCG.0000000000001145
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Aim: To investigate the pancreatic hormone responses to mixed meal test, in particular changes in insulin secretion, insulin sensitivity, and their interrelationship, in individuals with new-onset prediabetes or diabetes after non-necrotizing acute pancreatitis (NODAP) compared with healthy controls. Methods: Twenty-nine individuals with NODAP and 29 age-and sex-matched healthy controls were recruited. All participants (after fasting for at least 8 h) were given 12 oz. of BOOST drink and blood samples were collected before and after stimulation to measure insulin, C-peptide, glucagon, and pancreatic polypeptide. Indices of insulin sensitivity (HOMA-IS, 1/fasting insulin, Raynaud, and Matsuda) and insulin secretion (HOMA-beta, Stumvoll, insulinogenic index 30' and 60') were calculated. Repeated measures analyses were conducted in the unadjusted and adjusted models. Results: Insulin and C-peptide levels were significantly higher in individuals with NODAP compared with controls during mixed meal test in both the unadjusted (P = 0.001 for both) and adjusted (P = 0.004 and P = 0.006, respectively) models. HOMA-IS (P = 0.005), 1/fasting insulin (P = 0.018), Raynaud index (P = 0.018), and Matsuda index (P = 0.021) were significantly lower in individuals with NODAP, whereas HOMA-beta (P = 0.028) and Stumvoll index (P = 0.013) were significantly higher. Glucagon and pancreatic polypeptide levels did not differ significantly between NODAP and controls during mixed meal test in both the unadjusted (P = 0.345 and P = 0.206, respectively) and adjusted (P = 0.359 and P = 0.158, respectively) models. Conclusions: Decreased insulin sensitivity, beta-cell compensation, and no significant change in postprandial levels of glucagon and pancreatic polypeptide characterize NODAP. The above findings may help develop an evidence-based protocol with a view to optimize control of glucose homeostasis in NODAP.
引用
收藏
页码:E11 / E20
页数:10
相关论文
共 40 条
[1]   Chronic Pancreatitis: Recent Advances and Ongoing Challenges - In brief [J].
Ahmad, SA ;
Wray, CJ ;
Rilo, HR ;
Choe, KA ;
Gelrud, A ;
Howington, J ;
Lowy, AM ;
Matthews, JB .
CURRENT PROBLEMS IN SURGERY, 2006, 43 (03) :127-238
[2]  
Amer Diabet Assoc, 2018, DIABETES CARE, V41, pS13, DOI [10.2337/dc18-S002, 10.2337/dc09-S062, 10.2337/dc12-S064, 10.2337/dc23-S002, 10.2337/dc19-S002]
[3]   Pancreatic function, quality of life and costs at long-term follow-up after acute pancreatitis [J].
Andersson, Bodil ;
Pendse, Marie-Louise ;
Andersson, Roland .
WORLD JOURNAL OF GASTROENTEROLOGY, 2010, 16 (39) :4944-4951
[4]   Indices of Insulin Secretion during a Liquid Mixed-Meal Test in Obese Youth with Diabetes [J].
Bacha, Fida ;
Gungor, Neslihan ;
Lee, Sojung ;
de las Heras, Javier ;
Arslanian, Silva .
JOURNAL OF PEDIATRICS, 2013, 162 (05) :924-929
[5]   Repaglinide versus insulin for newly diagnosed diabetes in patients with cystic fibrosis: a multicentre, open-label, randomised trial [J].
Ballmann, Manfred ;
Hubert, Dominique ;
Assael, Baroukh M. ;
Staab, Doris ;
Hebestreit, Alexandra ;
Naehrlich, Lutz ;
Nickolay, Tanja ;
Prinz, Nicole ;
Holl, Reinhard W. .
LANCET DIABETES & ENDOCRINOLOGY, 2018, 6 (02) :114-121
[6]   Accurate assessment of β-cell function -: The hyperbolic correction [J].
Bergman, RN ;
Ader, M ;
Huecking, K ;
Van Citters, G .
DIABETES, 2002, 51 :S212-S220
[7]  
Cerf Marlon E, 2013, Front Endocrinol (Lausanne), V4, P37, DOI 10.3389/fendo.2013.00037
[8]   Newly diagnosed diabetes mellitus after acute pancreatitis: a systematic review and meta-analysis [J].
Das, Stephanie L. M. ;
Singh, Primal P. ;
Phillips, Anthony R. J. ;
Murphy, Rinki ;
Windsor, John A. ;
Petrov, Maxim S. .
GUT, 2014, 63 (05) :818-831
[9]   Determinant-Based Classification of Acute Pancreatitis Severity An International Multidisciplinary Consultation [J].
Dellinger, E. Patchen ;
Forsmark, Christopher E. ;
Layer, Peter ;
Levy, Philippe ;
Maravi-Poma, Enrique ;
Petrov, Maxim S. ;
Shimosegawa, Tooru ;
Siriwardena, Ajith K. ;
Uomo, Generoso ;
Whitcomb, David C. ;
Windsor, John A. .
ANNALS OF SURGERY, 2012, 256 (06) :875-880
[10]   Evaluation of a Mixed Meal Test for Diagnosis and Characterization of PancrEaTogEniC DiabeTes Secondary to Pancreatic Cancer and Chronic Pancreatitis: Rationale and Methodology for the DETECT Study From the Consortium for the Study of Chronic Pancreatitis, Diabetes, and Pancreatic Cancer [J].
Hart, Phil A. ;
Andersen, Dana K. ;
Mather, Kieren J. ;
Castonguay, Alicia C. ;
Bajaj, Mandeep ;
Bellin, Melena D. ;
Bradley, David ;
Contreras, Noemy ;
Habtezion, Aida ;
Korc, Murray ;
Kudva, Yogish ;
Petrov, Maxim S. ;
Whitcomb, David C. ;
Yadav, Dhiraj ;
Yuan, Ying ;
Rinaudo, Jo Ann S. ;
Srivastava, Sudhir ;
Serrano, Jose ;
Goodarzi, Mark O. .
PANCREAS, 2018, 47 (10) :1239-1243