Features of carbohydrate metabolism and incretin secretion in patients with Cushing disease and acromegaly
Aim. This study aims to analyse the rhythm and levels of incretins and neuropeptides secretion in patients with Cushing disease (CD) and acromegaly, and thus specify the pathogenesis of carbohydrate metabolism disturbances. Matherials and methods. In this study, 42 patients (mean age, 37.5 years) wi...
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| Format: | Article |
| Language: | English |
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Endocrinology Research Centre
2017-10-01
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| Series: | Сахарный диабет |
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| Online Access: | https://www.dia-endojournals.ru/jour/article/view/8672 |
| _version_ | 1797255165661675520 |
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| author | Lubov V. Matchekhina Ekaterina A. Shestakova Zhanna E. Belaya Lyudmila I. Astafieva Larisa V. Nikankina Marina V. Shestakova |
| author_facet | Lubov V. Matchekhina Ekaterina A. Shestakova Zhanna E. Belaya Lyudmila I. Astafieva Larisa V. Nikankina Marina V. Shestakova |
| author_sort | Lubov V. Matchekhina |
| collection | DOAJ |
| description | Aim. This study aims to analyse the rhythm and levels of incretins and neuropeptides secretion in patients with Cushing disease (CD) and acromegaly, and thus specify the pathogenesis of carbohydrate metabolism disturbances. Matherials and methods. In this study, 42 patients (mean age, 37.5 years) with CD and acromegaly were enrolled. All patients were newly diagnosed with CD and acromegaly, and none had a history of previous drug therapy, radiotherapy or pituitary surgery. All patients underwent OGTT, during which glucose, glucagon, GLP-1, GLP-2, GIP and ghrelin were evaluated at 0, 30 and 120 min, respectively. Results. During OGTT, glucose levels were not significantly different between the groups. The relevance of pre-diabetes was higher in patients with CD. In these patients, while glucagon levels were substantially higher at all cut-off points than those in controls (р = 0.001), GIP secretion was slightly lower. The acromegaly group was characterised by an inverse rhythm of GIP secretion with no peak level at 30 min. In addition, GLP-1 levels were significantly higher in patients with CD (р = 0.047). Similarly, GLP-2 levels were also significantly higher in patients with CD than in those with acromegaly and controls (p = 0.001). Finally, ghrelin levels were significantly higher in patients with CD (р = 0.013) and acromegaly (р = 0.023). Conclusion. More pleiotropic actions of glucocorticoids can explain the higher relevance of carbohydrate metabolism disturbances in patients with CD. This can also be explained by higher levels of glucagon secretion, which do not depend on the type of carbohydrate metabolism disorder and are stimulated by a direct action of glucocorticoids on the glucagon receptor. GIP and GLP-1 secretion in patients with CD and acromegaly are characterised by the inverse rhythm with no peak levels, implying that these hormones do not play a crucial role in the development of carbohydrate disturbances in these patients. In contrast, GLP-2 and ghrelin seem to influence and potentially regulate glucose homeostasis in patients with CD and acromegaly. |
| first_indexed | 2024-03-08T15:20:35Z |
| format | Article |
| id | doaj.art-b57c1f2833ba43a49646e293f39890b8 |
| institution | Directory Open Access Journal |
| issn | 2072-0351 2072-0378 |
| language | English |
| last_indexed | 2024-04-24T22:01:31Z |
| publishDate | 2017-10-01 |
| publisher | Endocrinology Research Centre |
| record_format | Article |
| series | Сахарный диабет |
| spelling | doaj.art-b57c1f2833ba43a49646e293f39890b82024-03-20T11:48:01ZengEndocrinology Research CentreСахарный диабет2072-03512072-03782017-10-0120424925610.14341/DM87627864Features of carbohydrate metabolism and incretin secretion in patients with Cushing disease and acromegalyLubov V. Matchekhina0Ekaterina A. Shestakova1Zhanna E. Belaya2Lyudmila I. Astafieva3Larisa V. Nikankina4Marina V. Shestakova5<p>Endocrinology Research Centre</p><p>Endocrinology Research Centre</p><p>Endocrinology Research Centre</p><p>N.N.Burdenko National Scientific and practical Centre for Neurosurgery</p><p>Endocrinology Research Centre</p><p>Endocrinology Research Centre</p>Aim. This study aims to analyse the rhythm and levels of incretins and neuropeptides secretion in patients with Cushing disease (CD) and acromegaly, and thus specify the pathogenesis of carbohydrate metabolism disturbances. Matherials and methods. In this study, 42 patients (mean age, 37.5 years) with CD and acromegaly were enrolled. All patients were newly diagnosed with CD and acromegaly, and none had a history of previous drug therapy, radiotherapy or pituitary surgery. All patients underwent OGTT, during which glucose, glucagon, GLP-1, GLP-2, GIP and ghrelin were evaluated at 0, 30 and 120 min, respectively. Results. During OGTT, glucose levels were not significantly different between the groups. The relevance of pre-diabetes was higher in patients with CD. In these patients, while glucagon levels were substantially higher at all cut-off points than those in controls (р = 0.001), GIP secretion was slightly lower. The acromegaly group was characterised by an inverse rhythm of GIP secretion with no peak level at 30 min. In addition, GLP-1 levels were significantly higher in patients with CD (р = 0.047). Similarly, GLP-2 levels were also significantly higher in patients with CD than in those with acromegaly and controls (p = 0.001). Finally, ghrelin levels were significantly higher in patients with CD (р = 0.013) and acromegaly (р = 0.023). Conclusion. More pleiotropic actions of glucocorticoids can explain the higher relevance of carbohydrate metabolism disturbances in patients with CD. This can also be explained by higher levels of glucagon secretion, which do not depend on the type of carbohydrate metabolism disorder and are stimulated by a direct action of glucocorticoids on the glucagon receptor. GIP and GLP-1 secretion in patients with CD and acromegaly are characterised by the inverse rhythm with no peak levels, implying that these hormones do not play a crucial role in the development of carbohydrate disturbances in these patients. In contrast, GLP-2 and ghrelin seem to influence and potentially regulate glucose homeostasis in patients with CD and acromegaly.https://www.dia-endojournals.ru/jour/article/view/8672acromegalycushing diseasecarbohydrate metabolism disturbancesincretinsneuropeptides |
| spellingShingle | Lubov V. Matchekhina Ekaterina A. Shestakova Zhanna E. Belaya Lyudmila I. Astafieva Larisa V. Nikankina Marina V. Shestakova Features of carbohydrate metabolism and incretin secretion in patients with Cushing disease and acromegaly Сахарный диабет acromegaly cushing disease carbohydrate metabolism disturbances incretins neuropeptides |
| title | Features of carbohydrate metabolism and incretin secretion in patients with Cushing disease and acromegaly |
| title_full | Features of carbohydrate metabolism and incretin secretion in patients with Cushing disease and acromegaly |
| title_fullStr | Features of carbohydrate metabolism and incretin secretion in patients with Cushing disease and acromegaly |
| title_full_unstemmed | Features of carbohydrate metabolism and incretin secretion in patients with Cushing disease and acromegaly |
| title_short | Features of carbohydrate metabolism and incretin secretion in patients with Cushing disease and acromegaly |
| title_sort | features of carbohydrate metabolism and incretin secretion in patients with cushing disease and acromegaly |
| topic | acromegaly cushing disease carbohydrate metabolism disturbances incretins neuropeptides |
| url | https://www.dia-endojournals.ru/jour/article/view/8672 |
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