EurekaMag.com logo
+ Translate

Pancreatic polypeptide administration improves abnormal glucose metabolism in patients with chronic pancreatitis


, : Pancreatic polypeptide administration improves abnormal glucose metabolism in patients with chronic pancreatitis. Journal of Clinical Endocrinology and Metabolism 81(10): 3566-3572

Chronic pancreatitis (CP) is associated with lowered plasma levels and a blunted nutrient-induced release of pancreatic polypeptide (PP). To investigate the possible role of PP on glucose metabolism, we studied male patients with documented CP (n = 5) and obesitymatched control subjects (NL) (n = 6). Hepatic glucose production (HGP) and overall glucose disposal rates were determined by (3-3H)glucose infusion during a hyperinsulinemic-euglycemic clamp during three separate admissions. Basal rates of HGP were higher in CP patients. In response to an infusion of insulin (60 pmol cntdot m-2 cntdot min-1), HGP fell 91 +- 5% in NL subjects but only 68 +- 8% in CP subjects (P lt 0.05). One month later, the clamp was repeated during the final 2 h of an 8-h infusion of bovine PP (2 pmol cntdot kg-1 cntdot min-1). HGP before the insulin infusion and its subsequent suppression (NL: 83 +- 5%; CP: 86 +- 15%) were nearly identical between groups. In follow-up studies 1 month after the PP infusion, HGP both basally and in response to insulin alone were similar to the first study. During oral glucose tolerance tests (OGTT) performed 18 h after the PP infusion, subjects with normal (n = 7) baseline OGTT responses showed no effect. All patients with diabetic (n = 3) or nondiagnostic (n = 1) OGTT responses, however, demonstrated lowered mean plasma glucose levels ( apprx - 2.3 mmol/L; range: -0.6 to -7.2 mmol/L). OGTTs repeated 1 month after the PP treatment showed a return to pretreatment responses. We conclude that chronic pancreatitis accompanied by PP deficiency is associated with partial hepatic resistance both in the basal state and in response to hyperinsulinemia. This impairment is reversed after iv PP administration. PP deficiency may therefore play a role in the development of pancreatogenic diabetes caused by pancreatic injury.

(PDF same-day service: $19.90)

Accession: 002914848

PMID: 8855802

DOI: 10.1210/jcem.81.10.8855802

Submit PDF Full Text: Here


Submit PDF Full Text

No spam - Every submission is manually reviewed

Due to poor quality, we do not accept files from Researchgate

Submitted PDF Full Texts will always be free for everyone
(We only charge for PDFs that we need to acquire)

Select a PDF file:
Close
Close

Related references

Sun, Y.S.; Brunicardi, F.C.; Druck, P.; Walfisch, S.; Berlin, S.A.; Chance, R.E.; Gingerich, R.L.; Elahi, D.; Andersen, D.K., 1986: Reversal of abnormal glucose metabolism in chronic pancreatitis by administration of pancreatic polypeptide. Chronic pancreatitis, induced in dogs by pancreatic duct ligation, is associated with glucose intolerance due to insulin deficiency, reduced hepatic sensitivity to insulin, and a marked deficiency of pancreatic polypeptide. Treatment with a 14 day...

Andersen D.K.; Brunicardi F.C.; Chaiken R.L.; Seymour N.E.; Lebovitz H.E.; Chance R.E.; Gingerich R.L.; Elahi D., 1988: Reversal of abnormal glucose metabolism in chronic pancreatitis by pancreatic polypeptide pp administration in man. Biomedical Research (Tokyo) 9(SUPPL 1): 27

Tanaka Y.; Druck P.; Brunicardi F.C.; Chance R.E.; Gingerich R.L.; Elahi D.; Andersen D.K., 1987: Reversal of abnormal glucose production in chronic pancreatitis by administration of gastric inhibitory polypeptide and pancreatic polypeptide. Surgical Forum (Chicago) 38: 149-151

Elahi D.; Sun Y.S.; Walfisch S.; Brunicardi F.C.; Berlin S.A.; Gingerich R.L.; Lebovitz H.E.; Andersen D.K., 1984: Interactions of pancreatic polypeptide glucagon and insulin on glucose metabolism in chronic pancreatitis. Digestive Diseases & Sciences 29(8 SUPPL): 24S

Seymour, N.E.; Brunicardi, F.C.; Chaiken, R.L.; Lebovitz, H.E.; Chance, R.E.; Gingerich, R.L.; Elahi, D.; Andersen, D.K., 1988: Reversal of abnormal glucose production after pancreatic resection by pancreatic polypeptide administration in man. Pancreatic polypeptide (PP) deficiency has been associated with impaired hepatic sensitivity to insulin and pancreatogenic diabetes in chronic pancreatitis. Since pancreatic resection might also result in PP deficiency, hepatic responses to insuli...

Seymour, N.E.; Volpert, A.R.; Inman, L.R.; Lee, E.L.; Brunicardi, F.C., 1995: Abnormal pancreatic polypeptide and somatostatin immunostaining in experimental chronic pancreatitis. Gastroenterology 108(4 SUPPL ): A390

Litwin, Jław.; Dobrowolski, S.; Orłowska-Kunikowska, E.; Sledziński, Z., 2008: Changes in glucose metabolism after Kausch-Whipple pancreatectomy in pancreatic cancer and chronic pancreatitis patients. Objective: Although changes in exocrine pancreatic function after pancreatoduodenectomy (PD) have been thoroughly analyzed in many reports, articles concerning endocrine have been few. An investigation of glucose metabolism changes in patients un...

Gregg, J.A.; Sharma, M.M., 1978: Endoscopic measurement of pancreatic juice secretory flow rates and pancreatic secretory pressures after secretin administration in human controls and in patients with acute relapsing pancreatitis, chronic pancreatitis, and pancreatic cancer. Secretory flow rates were measured inside the main pancreatic duct during endoscopic retrograde cholangiopancreatography (ERCP) in patients with acute relapsing pancreatitis, chronic pancreatitis, and pancreatic cancer and in controls after intrav...

Eddes, E.; Verkijk, M.; Gielkens, H.; Biemond, I.; Bemelman, W.; Lamers, C.; Masclee, A., 2003: Pancreatic Polypeptide Secretion in Patients with Chronic Pancreatitis and After Pancreatic Surgery. Pancreatic polypeptide (PP) is a 36-amino acidpolypeptide with a molecular weight of 4200 (1). PP is mainly produced in the head of the pancreas in adistinct cell type both within the islets and scatteredamong the exocrine parenchyma (2,3). PP rel...

Valenzuela, J.E.; Taylor, I.L.; Walsh, J.H., 1979: Pancreatic polypeptide response in patients with chronic pancreatitis. We studied the plasma pancreatic polypeptide (PP) response to a meal in patients with pancreatitis and attempted to correlate the PP increment with the degree of pancreatic exocrine insufficiency. Control subjects and patients with recurrent pancr...