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Cited by 51Pancreatic function and diabetesNeuroendocrine Tumor Research AdvancesPancreatic and Hepatic Oncology Research

Pancreatic polypeptide response to a mixed meal is blunted in pancreatic head cancer associated with diabetes mellitus

Hart, Phil A., Baichoo, Esha, Bi, Yan, Hinton, Alice, Kudva, Yogish C., Chari, Suresh T.·2015·Pancreatology
DOI 10.1016/j.pan.2015.02.006
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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.

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  • A small pilot study suggested that pancreatic ductal adenocarcinoma-associated diabetes may be distinguished from type 2 diabetes by a blunted pancreatic polypeptide response to a mixed meal.

    “A small pilot study suggested that pancreatic ductal adenocarcinoma-associated diabetes might be distinguished from the more prevalent type 2 diabetes by a blunted pancreatic polypeptide response to a mixed meal.94”

    From Early detection of pancreatic cancer (2020) · cites this paper as [94]

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Authors
Hart, P. A., Baichoo, E., Bi, Y., Hinton, A., Kudva, Y. C., & Chari, S. T.
Affiliations
  • Mayo Clinic (US)
  • The Ohio State University (US)
Corresponding author
Chari, Suresh T.
ORCID
Venue
Pancreatology
Publisher
Elsevier BV
Published
2015-03
Volume
15
Issue
2
Pages
162-166
ISSN
1424-3903 (ISSN-L)
DOI
10.1016/j.pan.2015.02.006
OpenAlex
W2061555972
Cited by
51
References
19
Citations by year
2026: 3 · 2025: 1 · 2024: 1 · 2023: 6 · 2022: 4 · 2021: 8 · 2020: 6 · 2019: 5 · 2018: 7 · 2017: 7 · 2016: 2 · 2015: 1
FWCI
6.38
Type
journal article
Language
en
Open access
closed
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • Pancreatology (publishedVersion)
  • PubMed (publishedVersion)
Funders
Mayo Clinic
Topics
  • Health Sciences › Medicine › Surgery › Pancreatic function and diabetes
  • Health Sciences › Medicine › Epidemiology › Neuroendocrine Tumor Research Advances
  • Health Sciences › Medicine › Oncology › Pancreatic and Hepatic Oncology Research
Keywords
pancreatic polypeptide, pancreatic head cancer, diabetes mellitus, type 2 diabetes, mixed meal tolerance, islet hormones, tumor location, cancer screening
MeSH terms
Aged, Diabetes Mellitus, Diabetes Mellitus, Type 2, Diagnosis, Differential, Eating, Female, Humans, Male, Middle Aged, Pancreas, Pancreatic Neoplasms, Pancreatic Polypeptide, Prospective Studies, Carcinoma, Pancreatic Ductal, Diabetes Complications

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