A Reduced Pancreatic Polypeptide Response is Associated With New-onset Pancreatogenic Diabetes Versus Type 2 Diabetes.

Autor:	Hart PA; Division of Gastroenterology, Hepatology, and Nutrition, The Ohio State University Wexner Medical Center, Columbus, OH 43210, USA., Kudva YC; Division of Endocrinology, Mayo Clinic College of Medicine, Rochester, MN 55905, USA., Yadav D; Division of Gastroenterology, Hepatology and Nutrition, University of Pittsburgh Medical Center, Pittsburgh, PA 15213, USA., Andersen DK; Division of Digestive Diseases and Nutrition, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD 20814, USA., Li Y; Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA., Toledo FGS; Division of Endocrinology and Metabolism, Department of Medicine, University of Pittsburgh, Pittsburgh, PA 15213, USA., Wang F; Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA., Bellin MD; Departments of Pediatrics and Surgery, University of Minnesota Medical School, Minneapolis, MN 55455, USA., Bradley D; Diabetes and Metabolism Research Center, Division of Endocrinology, Diabetes & Metabolism, The Ohio State University Wexner Medical Center, Columbus, OH 43210, USA., Brand RE; Division of Gastroenterology, Hepatology and Nutrition, University of Pittsburgh Medical Center, Pittsburgh, PA 15213, USA., Cusi K; Division of Endocrinology & Metabolism, University of Florida, Gainesville, FL 32611, USA., Fisher W; Department of Surgery, Baylor College of Medicine, Houston, TX 77030, USA., Mather K; Division of Endocrinology, Indiana University School of Medicine, Indianapolis, IN 46202, USA., Park WG; Division of Gastroenterology & Hepatology, Stanford University School of Medicine, Stanford, CA 94305, USA., Saeed Z; Division of Endocrinology, Indiana University School of Medicine, Indianapolis, IN 46202, USA., Considine RV; Division of Endocrinology, Indiana University School of Medicine, Indianapolis, IN 46202, USA., Graham SC; Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA., Rinaudo JA; Cancer Biomarker Research Group, Division of Cancer Prevention, National Cancer Institute, National Institutes of Health, Rockville, MD 20850, USA., Serrano J; Division of Digestive Diseases and Nutrition, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD 20814, USA., Goodarzi MO; Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA.
Jazyk:	angličtina
Zdroj:	The Journal of clinical endocrinology and metabolism [J Clin Endocrinol Metab] 2023 Apr 13; Vol. 108 (5), pp. e120-e128.
DOI:	10.1210/clinem/dgac670
Abstrakt:	Purpose: Pancreatogenic diabetes refers to diabetes mellitus (DM) that develops in the setting of a disease of the exocrine pancreas, including pancreatic ductal adenocarcinoma (PDAC) and chronic pancreatitis (CP). We sought to evaluate whether a blunted nutrient response of pancreatic polypeptide (PP) can differentiate these DM subtypes from type 2 DM (T2DM). Methods: Subjects with new-onset DM (<3 years' duration) in the setting of PDAC (PDAC-DM, n = 28), CP (CP-DM, n = 38), or T2DM (n = 99) completed a standardized mixed meal tolerance test, then serum PP concentrations were subsequently measured at a central laboratory. Two-way comparisons of PP concentrations between groups were performed using Wilcoxon rank-sum test and analysis of covariance while adjusting for age, sex, and body mass index. Results: The fasting PP concentration was lower in both the PDAC-DM and CP-DM groups than in the T2DM group (P = 0.03 and <0.01, respectively). The fold change in PP at 15 minutes following meal stimulation was significantly lower in the PDAC-DM (median, 1.869) and CP-DM (1.813) groups compared with T2DM (3.283; P < 0.01 for both comparisons). The area under the curve of PP concentration was significantly lower in both the PDAC-DM and CP-DM groups than in T2DM regardless of the interval used for calculation and remained significant after adjustments. Conclusions: Fasting PP concentrations and the response to meal stimulation are reduced in new-onset DM associated with PDAC or CP compared with T2DM. These findings support further investigations into the use of PP concentrations to characterize pancreatogenic DM and to understand the pathophysiological role in exocrine pancreatic diseases (NCT03460769). Competing Interests: Conflict of Interest M.D.B. discloses research support from Viacyte and Dexcom, DSMB membership for Insulet, and advisory board for Ariel Precision Medicine. Y.C.K. reports research support from Dexcom and advisory Board for Novo Nordisk Inc. K.M. is currently employed by Eli Lilly and Company. His contribution to this work preceded, and was independent of, this employment. None of the other authors have potential conflicts. (Published by Oxford University Press on behalf of the Endocrine Society 2022.)
Databáze:	MEDLINE
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