دورية أكاديمية
Pretransplant HOMA-β Is Predictive of Insulin Independence in 7 Patients With Chronic Pancreatitis Undergoing Islet Autotransplantation
| العنوان: | Pretransplant HOMA-β Is Predictive of Insulin Independence in 7 Patients With Chronic Pancreatitis Undergoing Islet Autotransplantation |
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| المؤلفون: | Christine A. Beamish, PhD, A. Osama Gaber, MD, Daniel W. Fraga, MBA, Dale J. Hamilton, MD, Omaima M. Sabek, PhD |
| المصدر: | Transplantation Direct, Vol 8, Iss 10, p e1367 (2022) |
| بيانات النشر: | Wolters Kluwer, 2022. |
| سنة النشر: | 2022 |
| المجموعة: | LCC:Surgery |
| مصطلحات موضوعية: | Surgery, RD1-811 |
| الوصف: | Background. Islet and β-cell function is intrinsic to glucose homeostasis. Pancreatectomy and islet autotransplantation (PIAT) for chronic pancreatitis (CP) treatment is a useful model for assessing islet function in the absence of immune-suppression and to perform extensive presurgical metabolic evaluations not possible from deceased donors. We recently showed that in CP-PIAT patients, preoperative islet identity loss presented with postoperative glycemic loss. Here, we examine presurgical islet function using Homeostatic Model Assessment-Beta Cell Function (%) (HOMA-β) and glycemic variables and compared them with postsurgical insulin independence and their predicted alignment with Secretory Unit of Islet Transplant Objects (SUITO) and beta cell score after transplantation (BETA-2) scores. Methods. Seven CP-PIAT patients were assessed for β-cell function metrics, including pretransplant and 6-mo posttransplant HOMA-β using insulin and C-peptide and evaluations of proposed insulin independence by SUITO and BETA-2 graft function equations. These were compared with oral glucose tolerance tests and pancreas histological samples taken at the time of transplant, examined for β-cell maturity markers. Results. Pre-PIAT, HOMA-β (60%−100%) associated with post-PIAT insulin independence. This association was only moderately supported by post-PIAT SUITO threshold scores (≥26) but robustly by BETA-2 scores (≥16.2). Appropriate posttransplant oral glucose tolerance test curves were found in those patients with normal pretransplant HOMA-β values. Preoperative low serological β-cell function was displayed by concurrent evidence of β-cell identity alterations including colocalization of insulin and glucagon, loss of urocortin-3, and increased intra-islet vimentin in patients who were insulin-dependent post-PIAT. Conclusions. These data encourage HOMA-β assessment before PIAT for estimating posttransplant insulin independence. |
| نوع الوثيقة: | article |
| وصف الملف: | electronic resource |
| اللغة: | English |
| تدمد: | 2373-8731 00000000 |
| العلاقة: | http://journals.lww.com/transplantationdirect/fulltext/10.1097/TXD.0000000000001367Test; https://doaj.org/toc/2373-8731Test |
| DOI: | 10.1097/TXD.0000000000001367 |
| الوصول الحر: | https://doaj.org/article/67aaf6596c58465387c2fbbe2f89996cTest |
| رقم الانضمام: | edsdoj.67aaf6596c58465387c2fbbe2f89996c |
| قاعدة البيانات: | Directory of Open Access Journals |
Full Text Finder | تدمد: | 23738731 00000000 |
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| DOI: | 10.1097/TXD.0000000000001367 |