Different post-pancreatectomy glucagon responses to a meal test between surgical approaches
Residual pancreatic endocrine function is important for maintaining metabolic status after pancreatectomy and is closely related to patient nutritional status and prognosis. In contrast to insulin secretion, the significance of glucagon secretion following pancreatectomy remains unclear. In this stu...
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| Format: | Article |
| Language: | English |
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The Japan Endocrine Society
2023-11-01
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| Series: | Endocrine Journal |
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| Online Access: | https://www.jstage.jst.go.jp/article/endocrj/70/11/70_EJ23-0032/_html/-char/en |
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| author | Tsuguka Matsuda Natsumi Himeno Akira Nakashima Naoya Nakagawa Toshihiko Kohashi Dan Kawamori Nozomu Kamei |
| author_facet | Tsuguka Matsuda Natsumi Himeno Akira Nakashima Naoya Nakagawa Toshihiko Kohashi Dan Kawamori Nozomu Kamei |
| author_sort | Tsuguka Matsuda |
| collection | DOAJ |
| description | Residual pancreatic endocrine function is important for maintaining metabolic status after pancreatectomy and is closely related to patient nutritional status and prognosis. In contrast to insulin secretion, the significance of glucagon secretion following pancreatectomy remains unclear. In this study, we assessed the changes in pancreatic glucagon secretion during pancreatectomy to determine their pathophysiological significance. We evaluated glucagon and insulin secretion using a liquid meal tolerance test before and after pancreatectomy in patients scheduled to undergo pancreaticoduodenectomy (PD) or distal pancreatectomy (DP). After pancreatectomy, fasting plasma glucagon levels were significantly decreased in both the PD (n = 10) and DP (n = 5) groups (PD: from 18.4 to 10.5 pg/mL, p = 0.037; DP: from 21.0 to 12.1 pg/mL, p = 0.043), whereas postprandial plasma glucagon levels were not changed. In the liquid meal tolerance test after pancreatectomy, 60-min plasma glucagon levels and the area under the curve (AUC) for 0–120 min of PD were significantly higher than those for DP (60-min plasma glucagon: PD 49.0 vs. DP 21.7 pg/mL, p = 0.040; AUC0–120min: PD 4,749 vs. DP 3,564 μg min/mL, p = 0.028). Postoperative plasma glucose, serum insulin, and serum C-peptide levels during the liquid meal tolerance test were not significantly different between the two groups. Although fasting plasma glucagon levels decreased, postprandial glucagon responses were maintained after both PD and DP. The difference in residual meal-stimulated glucagon response between PD and DP suggests that a relative excess of postprandial glucagon is involved in the postoperative nutritional status after PD through its impact on systemic metabolic status. |
| format | Article |
| id | doaj-art-2bf815c12e72454fb14a7404ccce380d |
| institution | Kabale University |
| issn | 1348-4540 |
| language | English |
| publishDate | 2023-11-01 |
| publisher | The Japan Endocrine Society |
| record_format | Article |
| series | Endocrine Journal |
| spelling | doaj-art-2bf815c12e72454fb14a7404ccce380d2025-01-22T06:23:18ZengThe Japan Endocrine SocietyEndocrine Journal1348-45402023-11-0170111077108510.1507/endocrj.EJ23-0032endocrjDifferent post-pancreatectomy glucagon responses to a meal test between surgical approachesTsuguka Matsuda0Natsumi Himeno1Akira Nakashima2Naoya Nakagawa3Toshihiko Kohashi4Dan Kawamori5Nozomu Kamei6Department of Endocrinology and Diabetic Medicine, Hiroshima University Hospital, Hiroshima 734-8551, JapanDepartment of Endocrinology and Diabetic Medicine, Hiroshima University Hospital, Hiroshima 734-8551, JapanDepartment of Surgery, Kure Kyosai Hospital, Hiroshima 737-8505, JapanDepartment of Surgery, Hiroshima City North Medical Center Asa Citizens Hospital, Hiroshima 731-0293, JapanDepartment of Surgery, Hiroshima City North Medical Center Asa Citizens Hospital, Hiroshima 731-0293, JapanDepartment of Metabolic Medicine, Osaka University Graduate School of Medicine, Osaka 565-0871, JapanDepartment of Endocrinology and Metabolism, Hiroshima Red Cross Hospital and Atomic Bomb Survivors Hospital, Hiroshima 730-8619, JapanResidual pancreatic endocrine function is important for maintaining metabolic status after pancreatectomy and is closely related to patient nutritional status and prognosis. In contrast to insulin secretion, the significance of glucagon secretion following pancreatectomy remains unclear. In this study, we assessed the changes in pancreatic glucagon secretion during pancreatectomy to determine their pathophysiological significance. We evaluated glucagon and insulin secretion using a liquid meal tolerance test before and after pancreatectomy in patients scheduled to undergo pancreaticoduodenectomy (PD) or distal pancreatectomy (DP). After pancreatectomy, fasting plasma glucagon levels were significantly decreased in both the PD (n = 10) and DP (n = 5) groups (PD: from 18.4 to 10.5 pg/mL, p = 0.037; DP: from 21.0 to 12.1 pg/mL, p = 0.043), whereas postprandial plasma glucagon levels were not changed. In the liquid meal tolerance test after pancreatectomy, 60-min plasma glucagon levels and the area under the curve (AUC) for 0–120 min of PD were significantly higher than those for DP (60-min plasma glucagon: PD 49.0 vs. DP 21.7 pg/mL, p = 0.040; AUC0–120min: PD 4,749 vs. DP 3,564 μg min/mL, p = 0.028). Postoperative plasma glucose, serum insulin, and serum C-peptide levels during the liquid meal tolerance test were not significantly different between the two groups. Although fasting plasma glucagon levels decreased, postprandial glucagon responses were maintained after both PD and DP. The difference in residual meal-stimulated glucagon response between PD and DP suggests that a relative excess of postprandial glucagon is involved in the postoperative nutritional status after PD through its impact on systemic metabolic status.https://www.jstage.jst.go.jp/article/endocrj/70/11/70_EJ23-0032/_html/-char/enpancreatectomyglucagoninsulin |
| spellingShingle | Tsuguka Matsuda Natsumi Himeno Akira Nakashima Naoya Nakagawa Toshihiko Kohashi Dan Kawamori Nozomu Kamei Different post-pancreatectomy glucagon responses to a meal test between surgical approaches Endocrine Journal pancreatectomy glucagon insulin |
| title | Different post-pancreatectomy glucagon responses to a meal test between surgical approaches |
| title_full | Different post-pancreatectomy glucagon responses to a meal test between surgical approaches |
| title_fullStr | Different post-pancreatectomy glucagon responses to a meal test between surgical approaches |
| title_full_unstemmed | Different post-pancreatectomy glucagon responses to a meal test between surgical approaches |
| title_short | Different post-pancreatectomy glucagon responses to a meal test between surgical approaches |
| title_sort | different post pancreatectomy glucagon responses to a meal test between surgical approaches |
| topic | pancreatectomy glucagon insulin |
| url | https://www.jstage.jst.go.jp/article/endocrj/70/11/70_EJ23-0032/_html/-char/en |
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