Assessment of simple indices based on a single fasting blood sample as a tool to estimate beta-cell function after total pancreatectomy with islet autotransplantation - a prospective study
Autor: | John J. Fung, Justyna Gołębiewska, Piotr Witkowski, Mark R Kijek, Piotr J. Bachul, Celeste C. Thomas, J Michael Millis, Alicja Dębska-Ślizień, Natalie Fillman, Karolina Gołąb, Jeffrey B. Matthews, Andres Gelrud, Lindsay Basto, Ling-Jia Wang, Martin Tibudan |
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Rok vydání: | 2018 |
Předmět: |
Adult
Blood Glucose Male medicine.medical_specialty Adolescent Total pancreatectomy medicine.medical_treatment Islets of Langerhans Transplantation Beta-cell Function 030230 surgery Transplantation Autologous Gastroenterology Graft function Young Adult 03 medical and health sciences Pancreatectomy 0302 clinical medicine Insulin-Secreting Cells Internal medicine medicine Humans Prospective Studies Prospective cohort study Transplantation geography geography.geographical_feature_category C-Peptide business.industry Insulin Fasting Middle Aged Islet Glucose/Creatinine Autotransplantation Female 030211 gastroenterology & hepatology business |
Zdroj: | Transplant International. 32:280-290 |
ISSN: | 0934-0874 |
Popis: | We investigated six indices based on a single fasting blood sample for evaluation of the beta-cell function after total pancreatectomy with islet autotransplantation (TP-IAT). The Secretory Unit of Islet Transplant Objects (SUITO), transplant estimated function (TEF), homeostasis model assessment (HOMA-2B%), C-peptide/glucose ratio (CP/G), C-peptide/glucose creatinine ratio (CP/GCr) and BETA-2 score were compared against a 90-min serum glucose level, weighted mean C-peptide in mixed meal tolerance test (MMTT), beta score and the Igls score adjusted for islet function in the setting of IAT. We analyzed values from 32 MMTTs in 15 patients after TP-IAT with a follow-up of up to 3 years. Four (27%) individuals had discontinued insulin completely prior to day 75, while 6 out of 12 patients (50%) did not require insulin support at 1-year follow-up with HbA1c 6.0% (5.5-6.8). BETA-2 was the most consistent among indices strongly correlating with all reference measures of beta-cell function (r = 0.62-0.68). In addition, it identified insulin independence (cut-off = 16.2) and optimal/good versus marginal islet function in the Igls score well, with AUROC of 0.85 and 0.96, respectively. Based on a single fasting blood sample, BETA-2 score has the most reliable discriminant value for the assessment of graft function in patients undergoing TP-IAT. |
Databáze: | OpenAIRE |
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