Acute insulin responses to calcium and tolbutamide do not differentiate focal from diffuse congenital hyperinsulinism.

Details

Serval ID
serval:BIB_C7A2CBEC0B28
Type
Article: article from journal or magazin.
Collection
Publications
Title
Acute insulin responses to calcium and tolbutamide do not differentiate focal from diffuse congenital hyperinsulinism.
Journal
Journal of Clinical Endocrinology and Metabolism
Author(s)
Giurgea I., Laborde K., Touati G., Bellanné-Chantelot C., Nassogne M.C., Sempoux C., Jaubert F., Khoa N., Chigot V., Rahier J., Brunelle F., Nihoul-Fékété C., Dunne M.J., Stanley C., Saudubray J.M., Robert J.J., de Lonlay P.
ISSN
0021-972X (Print)
ISSN-L
0021-972X
Publication state
Published
Issued date
2004
Peer-reviewed
Oui
Volume
89
Number
2
Pages
925-929
Language
english
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov'tPublication Status: ppublish
Abstract
Congenital hyperinsulinism (CHI) is related to two main histological pancreas anomalies: focal adenomatous hyperplasia and diffuse beta-cell hypersecretion. Pharmacological tests to measure acute insulin responses (AIR) to peripheral i.v. injections of glucose, calcium, and tolbutamide have been reported as potential means to distinguish between these histological forms. In patients with defects in ATP-sensitive potassium channels, tolbutamide will fail to induce insulin release in affected portions of the pancreas, whereas calcium gluconate will enhance insulin release through spontaneously active voltage-gated Ca(2+) channels. Consequently, in focal CHI patients, calcium should promote AIRs from the lesion, whereas tolbutamide should act to promote insulin secretion from the healthy region of the pancreas (outside the focal hyperplasia). We therefore studied AIRs to calcium and tolbutamide stimulation tests in 16 children with focal (n = 9) or diffuse (n = 7) CHI before pancreatic surgery. We found hypervariable AIRs to glucose and calcium stimulation in both focal and diffuse CHI patients. AIRs to tolbutamide stimulation were found modest in focal CHI patients, which might account for beta-cell quiescence in the healthy portion of the pancreas of these patients. We conclude that AIRs to calcium and tolbutamide stimulation tests are not sufficient to differentiate the focal from the diffuse CHI patients.
Keywords
Calcium Gluconate/administration & dosage, Child, Preschool, Diagnosis, Differential, Female, Glucose Tolerance Test, Humans, Hyperinsulinism/classification, Hyperinsulinism/congenital, Hypoglycemic Agents, Infant, Infant, Newborn, Injections, Intravenous, Insulin/secretion, Male, Tolbutamide
Pubmed
Web of science
Open Access
Yes
Create date
20/10/2016 16:25
Last modification date
20/08/2019 15:42
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