PMID- 38344778
OWN - NLM
STAT- Publisher
LR  - 20240417
IS  - 1945-7197 (Electronic)
IS  - 0021-972X (Linking)
DP  - 2024 Feb 12
TI  - Differential diagnosis of post pancreatitis diabetes mellitus based on pancreatic 
      and gut hormone characteristics.
LID - dgae080 [pii]
LID - 10.1210/clinem/dgae080 [doi]
AB  - PURPOSE: Distinguishing different types of diabetes is important in directing 
      optimized treatment strategies and correlated epidemiological studies. Through 
      detailed analysis of hormone responses to mixed meal tolerance test (MMTT), we 
      aimed to find representing characteristics of post-acute pancreatitis diabetes 
      mellitus (PPDM-A) and post-chronic pancreatitis diabetes mellitus (PPDM-C). 
      METHODS: Participants with PPDM-A, PPDM-C, type 1 diabetes, type 2 diabetes and 
      normal controls underwent MMTT. Fasting and postprandial responses of serum 
      glucose, C-peptide, insulin, glucagon, pancreatic polypeptide (PP), ghrelin, 
      gastric inhibitory peptide (GIP), glucagon like peptide-1 (GLP-1) and peptide YY 
      (PYY) were detected and compared among different groups. Focused analysis on 
      calculated insulin sensitivity and secretion indices were performed to reason 
      major causes of hyperglycemia in different conditions. RESULTS: Participants with 
      PPDM-A were characterized by increased C-peptide, insulin, glucagon and PP, while 
      decreased ghrelin, GIP and PYY compared with controls. Patients with PPDM-C 
      showed secretion insufficiency of C-peptide, insulin, ghrelin and PYY, higher 
      postprandial responses of glucagon and PP than controls. In particular, both 
      fasting and postprandial levels of ghrelin in PPDM-C were significantly lower 
      than other diabetes groups. PYY responses in patients with PPDM-A and PPDM-C were 
      markedly reduced. Besides, the insulin sensitivity of PPDM-A was decreased, and 
      the insulin secretion for PPDM-C was decreased. CONCLUSIONS: Along with the 
      continuum from acute to chronic pancreatitis, the pathological mechanism of PPDM 
      changes from insulin resistance to insulin deficiency. Insufficient PYY secretion 
      is a promising diagnostic marker for distinguishing PPDM from type 1 and type 2 
      diabetes. Absent ghrelin secretion to MMTT may help identify PPDM-C.
CI  - (c) The Author(s) 2024. Published by Oxford University Press on behalf of the 
      Endocrine Society. All rights reserved. For permissions, please e-mail: 
      journals.permissions@oup.com.
FAU - Lv, Yingqi
AU  - Lv Y
AD  - Division of Endocrinology, Zhongda Hospital, School of Medicine, Southeast 
      University, Nanjing 210009, China.
FAU - Lu, Xuejia
AU  - Lu X
AD  - Nanjing Medical University, Nanjing 210009, China.
AD  - Division of Gastroenterology, Zhongda Hospital Affiliated to Southeast 
      University, Nanjing 210009, China.
FAU - Liu, Gaifang
AU  - Liu G
AD  - Division of Gastroenterology, Hebei General Hospital, Shijiazhuang 050000, China.
FAU - Qi, Liang
AU  - Qi L
AD  - Division of Endocrinology, Zhongda Hospital, School of Medicine, Southeast 
      University, Nanjing 210009, China.
FAU - Zhong, Zihang
AU  - Zhong Z
AD  - Department of Biostatistics, School of Public Health, Nanjing Medical University, 
      Nanjing 210009, China.
FAU - Wang, Xiaoyuan
AU  - Wang X
AD  - Division of Endocrinology, Zhongda Hospital, School of Medicine, Southeast 
      University, Nanjing 210009, China.
FAU - Zhang, Weizhen
AU  - Zhang W
AD  - Department of Physiology and Pathophysiology, School of Basic Medical Sciences, 
      Peking University, Beijing 100191, China.
FAU - Shi, Ruihua
AU  - Shi R
AD  - Nanjing Medical University, Nanjing 210009, China.
AD  - Division of Gastroenterology, Zhongda Hospital Affiliated to Southeast 
      University, Nanjing 210009, China.
FAU - Goodarzi, Mark O
AU  - Goodarzi MO
AUID- ORCID: 0000-0001-6364-5103
AD  - Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, 
      Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA.
FAU - Pandol, Stephen J
AU  - Pandol SJ
AD  - Division of Gastroenterology, Department of Medicine, Cedars-Sinai Medical 
      Center, Los Angeles, CA 90048, USA.
FAU - Li, Ling
AU  - Li L
AUID- ORCID: 0000-0003-0083-6978
AD  - Division of Endocrinology, Zhongda Hospital, School of Medicine, Southeast 
      University, Nanjing 210009, China.
LA  - eng
PT  - Journal Article
DEP - 20240212
PL  - United States
TA  - J Clin Endocrinol Metab
JT  - The Journal of clinical endocrinology and metabolism
JID - 0375362
SB  - IM
CIN - J Clin Endocrinol Metab. 2024 Mar 19;:. PMID: 38501454
EIN - J Clin Endocrinol Metab. 2024 Apr 17;:. PMID: 38630627
OTO - NOTNLM
OT  - Biomarker
OT  - Diabetes of the exocrine pancreas
OT  - Differential diagnosis
OT  - Hormone responses
OT  - Mixed meal tolerance test
OT  - Post pancreatitis diabetes mellitus
EDAT- 2024/02/12 15:42
MHDA- 2024/02/12 15:42
CRDT- 2024/02/12 04:43
PHST- 2023/11/09 00:00 [received]
PHST- 2024/01/20 00:00 [revised]
PHST- 2024/02/06 00:00 [accepted]
PHST- 2024/02/12 15:42 [medline]
PHST- 2024/02/12 15:42 [pubmed]
PHST- 2024/02/12 04:43 [entrez]
AID - 7606470 [pii]
AID - 10.1210/clinem/dgae080 [doi]
PST - aheadofprint
SO  - J Clin Endocrinol Metab. 2024 Feb 12:dgae080. doi: 10.1210/clinem/dgae080.