Insulin Secretion and Insulin Sensitivity Before and After Surgical Treatment of Pheochromocytoma or Paraganglioma

• Komada, Hisako

• Hirota, Yushi

• So, Anna

• Nakamura, Tomoaki

• Okuno, Yoko

• Fukuoka, Hidenori

• Iguchi, Genzo

• Takahashi, Yutaka

• Sakaguchi, Kazuhiko

• Ogawa, Wataru

Abstract

Context:Pheochromocytoma and paraganglioma are catecholamine-producing tumors that oftenimpair glucose tolerance. The effects of these tumors on insulin sensitivity and insulin secretion inpatients have remained unclear, however.Objective:To characterize the influence of pheochromocytoma or paraganglioma on glucosetolerance, we comprehensively analyzed various parameters related to insulin secretion or insulinsensitivity in patients with these tumors.Design:Hyperglycemic and hyperinsulinemic-euglycemic clamps, as well as an oral glucose tolerancetest (OGTT), were performed in patients before and after tumor excision.Setting:Patients underwent metabolic analyses on admission to Kobe University Hospital.Patients:Eleven patients with pheochromocytoma and two with paraganglioma were examined.Intervention:None.Main Outcome Measures:We evaluated various parameters related to insulin secretion or insulinsensitivity as determined by an OGTT and by hyperglycemic and hyperinsulinemic-euglycemicclamp analyses.Results:Surgical treatment of the tumor reduced urinary catecholamine excretion and improvedglucose tolerance. The insulinogenic index, but not total insulin secretion, measured during theOGTT as well as the first phase, but not the second phase, of insulin secretion during the hyper-glycemic clamp were improved after surgery. The insulin sensitivity index determined during thehyperinsulinemic-euglycemic clamp remained unchanged after surgery.Conclusion:These results suggest pheochromocytoma and paraganglioma impair glucose toleranceprimarily through impairment of insulin secretion—in particular, that of the early phase of theinsulin secretory response. A prospective study with more patients is warranted to further confirmthese results.(J Clin Endocrinol Metab102: 3400–3405, 2017)

Journal

• The Journal of Clinical Endocrinology & Metabolism

  The Journal of Clinical Endocrinology & Metabolism 102 (9), 3400-3405, 2017-09-01

  Oxford University Press

Keywords

• Biochemistry (medical)
• Clinical Biochemistry
• Endocrinology
• Biochemistry
• Endocrinology, Diabetes and Metabolism

Details

• CRID: 1050012570393136512
• NII Article ID: 120006554638
• NII Book ID: AA00695484
• DOI: 10.1210/jc.2017-00357
• ISSN: 19457197
• ISSN: 0021972X
• HANDLE: 20.500.14094/90005591
• Web Site: http://academic.oup.com/jcem/article-pdf/102/9/3400/19703384/jc.2017-00357.pdf
• Text Lang: en
• Article Type: journal article
• Data Source:
  • IRDB
  • Crossref
  • CiNii Articles
  • KAKEN