PMID- 32337515
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220813
VI  - 2019
DP  - 2019
TI  - Beta Cell Stress in Insulin Independent Subjects Following Total Pancreatectomy 
      and Autologous Islet Transplantation.
PG  - 39-44
AB  - In patients with chronic pancreatitis (CP), autologous islet transplantation 
      (AIT) is often coupled with total pancreatectomy (TP) in aims to preserve 
      patients' insulin secretory function. Despite a third of patients achieving 
      insulin independence post-total pancreatectomy and autologous islet 
      transplantation (TPAIT), many will require the addition of insulin therapy for 
      maintenance of glycemic control overtime. We aimed through this study to 
      investigate the early metabolic profile signature of insulin independent subjects 
      post-TPAIT, specifically exploring markers of beta cell stress in this cohort. In 
      a prospective study design, we identified 37 subjects who underwent TPAIT between 
      2008 and 2017. Metabolic parameters were assessed using mixed meal tolerance test 
      data (MMTT), and the insulin-to-proinsulin index ratio, a marker of beta cell 
      stress. Assessments between metabolic variables were evaluated using the Wilcoxon 
      signed rank test. A significance level of 0.05 was assumed for all comparisons. 
      At a mean (+/-standard deviation) follow up duration of 37.7+/-17 months post-TPAIT, 
      11 patients (30%) were insulin independent with a mean HbA1C of 5.85+/-0.42%. 
      Despite adequate glycemic control in the latter cohort, we observed significantly 
      higher median peak glucose (180.5 versus 115.0 mg/dL; p=0.031), and lower median 
      fasting C-peptide (0.95 versus 1.5 ng/mL; p=0.008) on post-TPAIT MMTT compared to 
      pre-TPAIT MMTT. Additionally, significantly lower insulin-to-proinsulin index AUC 
      ratio was seen post-TPAIT compared to pre-TPAIT (p=0.022). A decline in the 
      proinsulin processing capacity, expressed by a lower insulin-to-proinsulin index 
      ratio was seen in insulin independent subjects post-TPAIT. Further studies 
      exploring the pathophysiology underlying these findings should be attained.
FAU - Ali, Khawla F
AU  - Ali KF
AUID- ORCID: 0000-0003-0685-8166
AD  - Cleveland Clinic, Endocrinology and Metabolism Institute, Cleveland, OH, USA.
FAU - San Martin, Vicente T
AU  - San Martin VT
AUID- ORCID: 0000-0002-4229-1972
AD  - Cleveland Clinic, Endocrinology and Metabolism Institute, Cleveland, OH, USA.
FAU - Hatipoglu, Betul
AU  - Hatipoglu B
AUID- ORCID: 0000-0002-5285-5858
AD  - Cleveland Clinic, Endocrinology and Metabolism Institute, Cleveland, OH, USA.
LA  - eng
GR  - R01 DK109124/DK/NIDDK NIH HHS/United States
PT  - Journal Article
DEP - 20190412
PL  - Turkey
TA  - Turk Klin Immunol Alerji
JT  - Turkiye klinikleri. Immunoloji alerji
JID - 101764954
PMC - PMC7182349
MID - NIHMS1578403
OTO - NOTNLM
OT  - Total pancreatectomy
OT  - autologous islet transplant
OT  - beta cell function
OT  - insulin independence
EDAT- 2019/01/01 00:00
MHDA- 2019/01/01 00:01
PMCR- 2020/04/24
CRDT- 2020/04/28 06:00
PHST- 2020/04/28 06:00 [entrez]
PHST- 2019/01/01 00:00 [pubmed]
PHST- 2019/01/01 00:01 [medline]
PHST- 2020/04/24 00:00 [pmc-release]
PST - ppublish
SO  - Turk Klin Immunol Alerji. 2019;2019:39-44. Epub 2019 Apr 12.