Preoperative insulin secretion ability and pancreatic parenchymal thickness as useful parameters for predicting postoperative insulin secretion in patients undergoing pancreaticoduodenectomy

DOI Web Site PubMed 2 Citations 49 References
  • Yoshikawa Atsushi
    Department of Metabolic Medicine, Graduate School of Medicine, Osaka University, Suita 565-0871, Japan
  • Kozawa Junji
    Department of Metabolic Medicine, Graduate School of Medicine, Osaka University, Suita 565-0871, Japan
  • Okita Kohei
    Department of Metabolic Medicine, Graduate School of Medicine, Osaka University, Suita 565-0871, Japan
  • Yoneda Sho
    Department of Metabolic Medicine, Graduate School of Medicine, Osaka University, Suita 565-0871, Japan
  • Okauchi Yukiyoshi
    Department of Metabolic Medicine, Graduate School of Medicine, Osaka University, Suita 565-0871, Japan
  • Uno Sae
    Department of Metabolic Medicine, Graduate School of Medicine, Osaka University, Suita 565-0871, Japan
  • Iwahashi Hiromi
    Department of Metabolic Medicine, Graduate School of Medicine, Osaka University, Suita 565-0871, Japan
  • Ohira Tetsuya
    Public Health, Department of Social and Environmental Medicine, Graduate School of Medicine, Osaka University, Suita 565-0871, Japan
  • Takiuchi Daisuke
    Department of Surgery, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, Suita 565-0871, Japan
  • Eguchi Hidetoshi
    Department of Surgery, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, Suita 565-0871, Japan
  • Takeda Yutaka
    Department of Surgery, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, Suita 565-0871, Japan
  • Imagawa Akihisa
    Department of Metabolic Medicine, Graduate School of Medicine, Osaka University, Suita 565-0871, Japan
  • Shimomura Iichiro
    Department of Metabolic Medicine, Graduate School of Medicine, Osaka University, Suita 565-0871, Japan

Search this article

Abstract

Periampullary malignant neoplasms have been increasing in Japan, mainly in response to an increase in the incidences of pancreatic cancer, and glucose intolerance due to deterioration of insulin secretion is an important problem. We investigated preoperative parameters to predict postoperative insulin secretion and the need for insulin therapy in patients undergoing pancreaticoduodenectomy (PD). Thirty-six patients with malignant neoplasms of periampullary lesions were enrolled. Preoperative pancreatic parenchymal thickness was evaluated by computed tomography. Insulin secretion and glucose tolerance were evaluated by a 75-g oral glucose tolerance test and an intravenous glucagon loading test. The relationships between postoperative insulin secretion and preoperative parameters and the cut-off values for predicting the need for postoperative insulin therapy for glycemic control were investigated. Pancreatic parenchymal thickness and other preoperative parameters, including the increment of serum C-peptide (Δ C-peptide), fasting plasma C-peptide (F-CPR), insulinogenic index (I.I.) and fasting plasma glucose (FPG), were significantly associated with postoperative insulin secretion. Multiple regression analyses revealed that preoperative Δ C-peptide or F-CPR was the most significant determinant of postoperative insulin secretion, followed by pancreatic parenchymal thickness. In the receiver operating characteristic curve, the best preoperative cut-off values for predicting the need for postoperative insulin therapy were a Δ C-peptide of 0.65 ng/mL, a F-CPR of 0.85 ng/mL and a pancreatic parenchymal thickness of 6.0 mm. Both preoperative insulin secretion and pancreatic parenchymal thickness effectively predict postoperative insulin secretion and identify subjects who need postoperative insulin therapy for glycemic control.

Journal

  • Endocrine Journal

    Endocrine Journal 59 (5), 383-392, 2012

    The Japan Endocrine Society

Citations (2)*help

See more

References(49)*help

See more

Related Projects

See more

Keywords

Details 詳細情報について

Report a problem

Back to top