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Determination of C-peptide levels during a glucose tolerance test in patients with pancreatic cancer


Authors: T. Novotná;  M. Bátovský
Authors‘ workplace: Gastroenterologická klinika SZU a UNB, UN sv. Cyrila a Metoda, Bratislava
Published in: Gastroent Hepatol 2014; 68(4): 325-329
Category: Clinical and Experimental Gastroenterology: Original Article

Overview

The mechanism responsible for diabetes mellitus (DM) in patients with pancreatic cancer remains controversial. The aim of our study is to verify that pancreatic cancer patients had lower C-peptide levels during an oral glucose tolerance test (oGTT) than the control subjects, regardless of the presence of diabetes mellitus, since until now only a few similar studies have been published.

Methods:
In our study we analysed C-peptide response at 120 minutes during the oGTT in 29 patients with pancreatic cancer and 23 patients with chronic pancreatitis – control subjects.

Results:
C-peptide levels, observed at 120 minutes during the oGTT in patients with pancreatic cancer, were not lower than those of control subjects, and the difference was not statistically significant (p = 0.257). By means of the oGTT, we detected diabetes mellitus in 15 (51%) patients in the pancreatic cancer group and in nine (39%) control subjects. There were no statistically significant differences in C-peptide levels in patients with and without DM, or in the pancreatic cancer group (p = 0.383) or in control subjects with chronic pancreatitis (p = 0.877).

Conclusions:
We did not confirm that a characteristic feature of pancreatic cancer patients is decreased C-peptide production during the oGTT in comparison with the control subjects. Further studies are needed in a large number of patients to assess the importance of impaired glucose tolerance or diabetes mellitus in pancreatic cancer detection.

Key words:
pancreatic cancer – diabetes mellitus – C-peptide

The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study.

The Editorial Board declares that the manuscript met the ICMJE „uniform requirements“ for biomedical papers.

Submitted:
14. 4. 2014

Accepted:
26. 5. 2014


Sources

1. Wakasugi H, Funakoshi A, Iguchi H. Clinical observations of pancreatic diabetes caused by pancreatic carcinoma, and survival period. Int J Clin Oncol 2001; 6(1): 50–54.

2. Nakamori S, Ishikawa O, Ohigashi H et al. Increased blood proinsulin and decreased C-peptide levels in patients with pancreatic cancer. Hepatogastroenterology 1999; 46(25): 16–24.

3. Gapstur SM, Gann PH, Lowe W et al. Abnormal glucose metabolism and pancreatic cancer mortality. JAMA 2000; 283(19): 2552–2558.

4. Kuang TT, Jin da Y, Wang DS et al. Clinical epidemiological analysis of the relationship between pancreatic cancer and diabetes mellitus: data from a single institution in China. J Dig Dis 2009; 10(1): 26–29. doi: 10.1111/j.1751-2980.2008.00359.x.

5. Ariyama J. Abnormal glucose tolerance in patients with early pancreatic carcinoma. Int J Pancreatol 1994; 91: 59–67.

6. Pannala R, Leirness JB, Bamlet WR et al. Prevalence and clinical profile of pancreatic cancer-associated diabetes mellitus. Gastroenterology 2008; 134(4): 981–987. doi: 10.1053/j.gastro.2008.01.039.

7. Aggarwal G, Rabe KG, Petersen GM et al. New-onset diabetes in pancreatic cancer: a study in the primary care setting. Pancreatology 2012; 12(2): 156–161. doi: 10.1016/j.pan.2012.02.003.

8. Aggarwal G, Kamada P, Chari ST. Prevalence of diabetes mellitus in pancreatic cancer compared to common cancers. Pancreas 2013; 42(2): 198–201. doi: 10.1097/MPA.0b013e3182592c96.

9. Permert J, Adrian TE, Jacobsson P et al. Is profound peripheral insulin resistance in patients with pancreatic cancer caused by a tumor-assotiated factor? Am J Surg 1993; 165(1): 61–66.

10. Chari ST, Leibson CL, Rabe KG et al. Pancreatic cancer-associated diabetes mellitus: prevalence and temporal assotiation with diagnosis of cancer. Gastroenterology 2008; 134(1): 95–101.

11. Tsuchiya R, Noda T, Harada N et al. Collective review of small carcinomas of the pancreas. Ann Surg 1986; 203(1): 77–81.

12. Chari ST, Leibson CL, Rabe KG et al. Probability of pancreatic cancer following diabetes: a population-based study. Gastroenterology 2005; 129(2): 504–511.

13. Nakamori S, Yashima K, Murakami Y et al. Association of p53 gene mutations with short survival in pancreatic adenocarcinoma. Jpn J Cancer Res 1995; 86(2): 174–181.

14. Basso D, Valerio A, Seraglia R et al. Putative pancreatic cancer-associated diabetogenic factor: 2030 MW peptide. Pancreas 2002; 24(1): 8–14.

15. Eckhauser FE, Colletti LM, Knol JA. Pancreatic carcinoma. Current Opinion in Gastroenterology 1995; 11(5): 414–422.

16. Ishikawa O, Ohigashi H, Imaoka S et al. Minute carcinoma of the pancreas measuring 1 cm or less in diameter – collective review of Japanese case reports. Hepatogastroenterology 1999; 46(25): 8–15.

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Paediatric gastroenterology Gastroenterology and hepatology Surgery

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