Impaired glucose-induced glucagon suppression after partial ...

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However, this does not exclude that systemic insulin concentrations would have an impact on glucagon release as well. Therefore, in the present study, we examined the effects of a hemi- pancreatectomy, leading to a ~50% reduction in both beta- and alpha-cell mass, on post- challenge glucagon levels in humans. For these purposes, 36 patients undergoing pancreatic surgery were studied before and after surgery. By these means, we addressed the questions: (1) Is the glucose-induced suppression of glucagon levels impaired after hemi-pancreatectomy in humans, and if so, (2) are the alterations in glucose-induced glucagon suppression related to the respective changes in glycaemia or insulin secretion? 4
Materials and methods Study design A total of 36 patients undergoing pancreatic surgery for chronic pancreatitis, pancreatic carcinoma, and benign pancreatic tumours were studied. All patients were examined before and after pancreatic surgery with a 240 min oral glucose challenge, and the respective changes in the plasma concentration profiles of glucose, insulin, C-peptide, and glucagon were determined. Parts of this study related to the changes in glucose, insulin and C-peptide levels after partial pancreatectomy have been communicated in a separate report (18). The study protocol was approved by the ethics committee of the Ruhr-University Bochum (registration number 2528). All patients provided written informed consent prior to study enrolment. Patients: A total of 36 patients (18 males, 18 females) undergoing pancreatic resections in the Department of Surgery, St. Josef-Hospital, Ruhr-University Bochum, between the years 2004 and 2007 were included. One patient from the original cohort (18) was excluded, because glucagon measurements were not available. The mean age of the patients was 59.4 ± 13.0 years, and the body mass index was 23.9 ± 4.2 kg/m 2 . Detailed patient characteristics have previously been reported (18). 14 patients were undergoing surgery for chronic pancreatitis, nine patients were treated for pancreatic adenocarcinoma, 12 patients underwent surgery for the removal of benign pancreatic adenomas, and one patient was undergoing surgery for because of a tumour of the papilla Vateri. In 12 patients, distal pancreatectomies (pancreas tail resection) were performed, whereas 24 patients were treated with a proximal pancreatectomy (pancreas head resection). The latter group comprised 17 patients undergoing pancreaticoduodenectomy with pylorus preservation, 6 patients undergoing duodenum-preserving pancreatic head resections according to Beger, and one patient undergoing classic partial pancreaticoduodenectomy (Whipple’s operation). 5
Page 1 and 2: J Clin Endocrin Metab. First publis
Page 3: Introduction: In health, glucose ho
Page 7 and 8: assay (ELISA) from DAKOP Ltd., Camb
Page 9 and 10: However, after pancreatic head rese
Page 11 and 12: cell secretion (34, 35). Consistent
Page 13 and 14: A number of previous studies in rat
Page 15 and 16: References: 1. Meier JJ, Butler PC
Page 17 and 18: 36. Robertson RP, Sutherland DE, Se
Page 19 and 20: Figure legends: Figure 1: Plasma co

Impaired glucose-induced glucagon suppression after partial ...

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