Phil A Hart1, Esha Baichoo2, Yan Bi2, Alice Hinton3, Yogish C Kudva4, Suresh T Chari5. 1. Division of Gastroenterology and Hepatology, Mayo Clinic Rochester, MN, USA; Division of Gastroenterology, Hepatology, and Nutrition, The Ohio State University, Columbus, OH, USA. 2. Division of Gastroenterology and Hepatology, Mayo Clinic Rochester, MN, USA. 3. Division of Biostatistics, College of Public Health, The Ohio State University, Columbus, OH, USA. 4. Division of Endocrinology, Mayo Clinic Rochester, MN, USA. 5. Division of Gastroenterology and Hepatology, Mayo Clinic Rochester, MN, USA. Electronic address: chari.suresh@mayo.edu.
Abstract
INTRODUCTION: Pancreatic polypeptide (PP) is a hormone secreted by islet cells of the ventral pancreas. It has been proposed that a blunted PP response to a mixed meal can distinguish diabetes mellitus (DM) secondary to pancreatic disease from other types of DM. We performed a proof of concept study to determine if PP response to a mixed meal discriminates DM secondary to pancreatic cancer (PaCDM) from type 2 DM (T2DM). METHODS: We studied 18 subjects with new onset DM (PaCDM (n = 9) and T2DM (n = 9); matched for age and gender). Serum PP levels were measured at 0, 30, and 60 min following a mixed meal. Increases in PP levels from baseline were compared using the Wilcoxon test. RESULTS: In PaCDM the PP increase following a mixed meal was less than T2DM at 30 min (median 60.0%, IQR, 33.0-119.8 vs. 134.5%, IQR, 117.5-265.9; p = 0.03), but statistically similar at 60 min (median 55.8%, interquartile range (IQR) 23.7-121.5 vs. 100.0%, IQR, 47.7-202.5; p = 0.17). In PaCDM subjects, the PP increase over baseline was smaller in those with a tumor located in the pancreatic head (n = 6) compared to the body/tail (n = 3) at 30 min (41.3% vs. 158.7%, p = 0.02) and at 60 min (37.4% vs. 167.4%,p = 0.04). CONCLUSIONS: Subjects with PaCDM have a blunted PP response to a mixed meal compared to T2DM. However, the blunted PP response is only observed in those PaC subjects with a tumor located in the head of the pancreas. Confirmation in larger studies may suggest this could be used to aid screening for sporadic PaC.
INTRODUCTION:Pancreatic polypeptide (PP) is a hormone secreted by islet cells of the ventral pancreas. It has been proposed that a blunted PP response to a mixed meal can distinguish diabetes mellitus (DM) secondary to pancreatic disease from other types of DM. We performed a proof of concept study to determine if PP response to a mixed meal discriminates DM secondary to pancreatic cancer (PaCDM) from type 2 DM (T2DM). METHODS: We studied 18 subjects with new onset DM (PaCDM (n = 9) and T2DM (n = 9); matched for age and gender). Serum PP levels were measured at 0, 30, and 60 min following a mixed meal. Increases in PP levels from baseline were compared using the Wilcoxon test. RESULTS: In PaCDM the PP increase following a mixed meal was less than T2DM at 30 min (median 60.0%, IQR, 33.0-119.8 vs. 134.5%, IQR, 117.5-265.9; p = 0.03), but statistically similar at 60 min (median 55.8%, interquartile range (IQR) 23.7-121.5 vs. 100.0%, IQR, 47.7-202.5; p = 0.17). In PaCDM subjects, the PP increase over baseline was smaller in those with a tumor located in the pancreatic head (n = 6) compared to the body/tail (n = 3) at 30 min (41.3% vs. 158.7%, p = 0.02) and at 60 min (37.4% vs. 167.4%,p = 0.04). CONCLUSIONS: Subjects with PaCDM have a blunted PP response to a mixed meal compared to T2DM. However, the blunted PP response is only observed in those PaC subjects with a tumor located in the head of the pancreas. Confirmation in larger studies may suggest this could be used to aid screening for sporadic PaC.
Authors: Phil A Hart; Melena D Bellin; Dana K Andersen; David Bradley; Zobeida Cruz-Monserrate; Christopher E Forsmark; Mark O Goodarzi; Aida Habtezion; Murray Korc; Yogish C Kudva; Stephen J Pandol; Dhiraj Yadav; Suresh T Chari Journal: Lancet Gastroenterol Hepatol Date: 2016-10-12
Authors: Stephen P Pereira; Lucy Oldfield; Alexander Ney; Phil A Hart; Margaret G Keane; Stephen J Pandol; Debiao Li; William Greenhalf; Christie Y Jeon; Eugene J Koay; Christopher V Almario; Christopher Halloran; Anne Marie Lennon; Eithne Costello Journal: Lancet Gastroenterol Hepatol Date: 2020-03-02
Authors: Phil A Hart; Dana K Andersen; Kieren J Mather; Alicia C Castonguay; Mandeep Bajaj; Melena D Bellin; David Bradley; Noemy Contreras; Aida Habtezion; Murray Korc; Yogish Kudva; Maxim S Petrov; David C Whitcomb; Dhiraj Yadav; Ying Yuan; Jo Ann S Rinaudo; Sudhir Srivastava; Jose Serrano; Mark O Goodarzi Journal: Pancreas Date: 2018 Nov/Dec Impact factor: 3.327
Authors: Dana K Andersen; Murray Korc; Gloria M Petersen; Guido Eibl; Donghui Li; Michael R Rickels; Suresh T Chari; James L Abbruzzese Journal: Diabetes Date: 2017-05 Impact factor: 9.461
Authors: Taylor M Gilliland; Nicole Villafane-Ferriol; Kevin P Shah; Rohan M Shah; Hop S Tran Cao; Nader N Massarweh; Eric J Silberfein; Eugene A Choi; Cary Hsu; Amy L McElhany; Omar Barakat; William Fisher; George Van Buren Journal: Nutrients Date: 2017-03-07 Impact factor: 5.717