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Endocrine Secretory Reserve and Proinsulin Processing in Recipients of Islet of Langerhans Versus Whole Pancreas Transplants
- Source :
- Diabetes Care, Vol. 36, No 11 (2013) pp. 3726-31, Diabetes Care, Diabetes care
- Publication Year :
- 2013
- Publisher :
- American Diabetes Association, 2013.
-
Abstract
- OBJECTIVE β-Cells have demonstrated altered proinsulin processing after islet transplantation. We compare β-cell metabolic responses and proinsulin processing in pancreas and islet transplant recipients with respect to healthy control subjects. RESEARCH DESIGN AND METHODS We studied 15 islet and 32 pancreas transplant recipients. Islet subjects were subdivided into insulin-requiring (IR-ISL, n = 6) and insulin-independent (II-ISL, n = 9) groups. Ten healthy subjects served as control subjects. Subjects were administered an intravenous arginine stimulation test, and insulin, C-peptide, total proinsulin, intact proinsulin, and proinsulin fragment levels were determined from serum samples. Acute insulin response (AIR) and proinsulin processing rates were calculated. RESULTS We found that basal insulin and C-peptide levels were higher in the pancreas group than in all other groups. II-ISL patients had basal insulin and C-peptide levels similar to healthy control subjects. The IR-ISL group had significantly lower AIRs than all other groups. Basal processing rates were higher in the pancreas and II-ISL groups than in healthy control subjects and the IR-ISL group. After arginine stimulation, all groups had elevated processing rates, with the exception of the IR-ISL group. CONCLUSIONS Our data suggest that II-ISL transplant recipients can maintain basal metabolic parameters similar to healthy control subjects at the cost of a higher rate of proinsulin processing. IR-ISL transplant recipients, on the other hand, demonstrate both lower insulin response and lower basal rates of proinsulin processing even after arginine stimulation.
- Subjects :
- Blood Glucose
Male
endocrine system diseases
Endocrinology, Diabetes and Metabolism
medicine.medical_treatment
Islets of Langerhans Transplantation
chemistry.chemical_compound
0302 clinical medicine
Insulin-Secreting Cells
Insulin
Original Research
Proinsulin
0303 health sciences
geography.geographical_feature_category
C-Peptide
ddc:617
C-peptide
Middle Aged
Islet
Female
Pancreas Transplantation
hormones, hormone substitutes, and hormone antagonists
Adult
endocrine system
medicine.medical_specialty
030209 endocrinology & metabolism
Pancreas transplantation
digestive system
03 medical and health sciences
Internal medicine
Diabetes mellitus
Internal Medicine
medicine
Humans
Pathophysiology/Complications
030304 developmental biology
Advanced and Specialized Nursing
geography
business.industry
nutritional and metabolic diseases
medicine.disease
Transplantation
Cross-Sectional Studies
Diabetes Mellitus, Type 1
Endocrinology
chemistry
Basal (medicine)
business
Subjects
Details
- ISSN :
- 19355548 and 01495992
- Volume :
- 36
- Database :
- OpenAIRE
- Journal :
- Diabetes Care
- Accession number :
- edsair.doi.dedup.....f4ab4cbf6388c7f6c9c6234224e5b594