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Proinsulin levels in patients with pancreatic diabetes are associated with functional changes in insulin secretion rather than pancreatic beta-cell area.
Eur J Endocrinol 2010; 163(4):551-8EJ

Abstract

INTRODUCTION

Hyperproinsulinaemia has been reported in patients with type 2 diabetes. It is unclear whether this is due to an intrinsic defect in β-cell function or secondary to the increased demand on the β-cells. We investigated whether hyperproinsulinaemia is also present in patients with secondary diabetes, and whether proinsulin levels are associated with impaired β-cell area or function.

PATIENTS AND METHODS

Thirty-three patients with and without diabetes secondary to pancreatic diseases were studied prior to pancreatic surgery. Intact and total proinsulin levels were compared with the pancreatic β-cell area and measures of insulin secretion and action.

RESULTS

Fasting concentrations of total and intact proinsulin were similar in patients with normal, impaired (including two cases of impaired fasting glucose) and diabetic glucose tolerance (P=0.58 and P=0.98 respectively). There were no differences in the total proinsulin/insulin or intact proinsulin/insulin ratio between the groups (P=0.23 and P=0.71 respectively). There was a weak inverse association between the total proinsulin/insulin ratio and pancreatic β-cell area (r(2)=0.14, P=0.032), whereas the intact proinsulin/insulin ratio and the intact and total proinsulin levels were unrelated to β-cell area. However, a strong inverse relationship between homeostasis model assessment index of β-cell function and both the total and the intact proinsulin/insulin ratio was found (r(2)=0.55 and r(2)=0.48 respectively). The association of insulin resistance (IR) with intact proinsulin was much weaker than the correlation with fasting insulin.

CONCLUSIONS

Hyperproinsulinaemia is associated with defects in insulin secretion rather than a reduction in β-cell area. The weak association between intact proinsulin and IR argues against the usefulness of this parameter in clinical practice.

Authors+Show Affiliations

Department of Medicine I, St Josef-Hospital, Ruhr-University Bochum, Gudrunstrasse 56, Bochum, Germany.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

20679359

Citation

Breuer, Thomas G K., et al. "Proinsulin Levels in Patients With Pancreatic Diabetes Are Associated With Functional Changes in Insulin Secretion Rather Than Pancreatic Beta-cell Area." European Journal of Endocrinology, vol. 163, no. 4, 2010, pp. 551-8.
Breuer TG, Menge BA, Banasch M, et al. Proinsulin levels in patients with pancreatic diabetes are associated with functional changes in insulin secretion rather than pancreatic beta-cell area. Eur J Endocrinol. 2010;163(4):551-8.
Breuer, T. G., Menge, B. A., Banasch, M., Uhl, W., Tannapfel, A., Schmidt, W. E., ... Meier, J. J. (2010). Proinsulin levels in patients with pancreatic diabetes are associated with functional changes in insulin secretion rather than pancreatic beta-cell area. European Journal of Endocrinology, 163(4), pp. 551-8. doi:10.1530/EJE-10-0330.
Breuer TG, et al. Proinsulin Levels in Patients With Pancreatic Diabetes Are Associated With Functional Changes in Insulin Secretion Rather Than Pancreatic Beta-cell Area. Eur J Endocrinol. 2010;163(4):551-8. PubMed PMID: 20679359.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Proinsulin levels in patients with pancreatic diabetes are associated with functional changes in insulin secretion rather than pancreatic beta-cell area. AU - Breuer,Thomas G K, AU - Menge,Bjoern A, AU - Banasch,Matthias, AU - Uhl,Waldemar, AU - Tannapfel,Andrea, AU - Schmidt,Wolfgang E, AU - Nauck,Michael A, AU - Meier,Juris J, Y1 - 2010/08/02/ PY - 2010/8/4/entrez PY - 2010/8/4/pubmed PY - 2010/10/7/medline SP - 551 EP - 8 JF - European journal of endocrinology JO - Eur. J. Endocrinol. VL - 163 IS - 4 N2 - INTRODUCTION: Hyperproinsulinaemia has been reported in patients with type 2 diabetes. It is unclear whether this is due to an intrinsic defect in β-cell function or secondary to the increased demand on the β-cells. We investigated whether hyperproinsulinaemia is also present in patients with secondary diabetes, and whether proinsulin levels are associated with impaired β-cell area or function. PATIENTS AND METHODS: Thirty-three patients with and without diabetes secondary to pancreatic diseases were studied prior to pancreatic surgery. Intact and total proinsulin levels were compared with the pancreatic β-cell area and measures of insulin secretion and action. RESULTS: Fasting concentrations of total and intact proinsulin were similar in patients with normal, impaired (including two cases of impaired fasting glucose) and diabetic glucose tolerance (P=0.58 and P=0.98 respectively). There were no differences in the total proinsulin/insulin or intact proinsulin/insulin ratio between the groups (P=0.23 and P=0.71 respectively). There was a weak inverse association between the total proinsulin/insulin ratio and pancreatic β-cell area (r(2)=0.14, P=0.032), whereas the intact proinsulin/insulin ratio and the intact and total proinsulin levels were unrelated to β-cell area. However, a strong inverse relationship between homeostasis model assessment index of β-cell function and both the total and the intact proinsulin/insulin ratio was found (r(2)=0.55 and r(2)=0.48 respectively). The association of insulin resistance (IR) with intact proinsulin was much weaker than the correlation with fasting insulin. CONCLUSIONS: Hyperproinsulinaemia is associated with defects in insulin secretion rather than a reduction in β-cell area. The weak association between intact proinsulin and IR argues against the usefulness of this parameter in clinical practice. SN - 1479-683X UR - https://www.unboundmedicine.com/medline/citation/20679359/Proinsulin_levels_in_patients_with_pancreatic_diabetes_are_associated_with_functional_changes_in_insulin_secretion_rather_than_pancreatic_beta_cell_area_ L2 - https://eje.bioscientifica.com/doi/10.1530/EJE-10-0330 DB - PRIME DP - Unbound Medicine ER -