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) w...

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Autores principales:	Lubov V. Matchekhina, Ekaterina A. Shestakova, Zhanna E. Belaya, Lyudmila I. Astafieva, Larisa V. Nikankina, Marina V. Shestakova
Formato:	article
Lenguaje:	EN RU
Publicado:	Endocrinology Research Centre 2017
Materias:	acromegaly cushing disease carbohydrate metabolism disturbances incretins neuropeptides Nutritional diseases. Deficiency diseases RC620-627
Acceso en línea:	https://doaj.org/article/b57c1f2833ba43a49646e293f39890b8
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spelling	oai:doaj.org-article:b57c1f2833ba43a49646e293f39890b82021-11-14T09:00:21ZFeatures of carbohydrate metabolism and incretin secretion in patients with Cushing disease and acromegaly2072-03512072-037810.14341/DM8762https://doaj.org/article/b57c1f2833ba43a49646e293f39890b82017-10-01T00:00:00Zhttps://www.dia-endojournals.ru/jour/article/view/8672https://doaj.org/toc/2072-0351https://doaj.org/toc/2072-0378Aim. 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.Lubov V. MatchekhinaEkaterina A. ShestakovaZhanna E. BelayaLyudmila I. AstafievaLarisa V. NikankinaMarina V. ShestakovaEndocrinology Research Centrearticleacromegalycushing diseasecarbohydrate metabolism disturbancesincretinsneuropeptidesNutritional diseases. Deficiency diseasesRC620-627ENRUСахарный диабет, Vol 20, Iss 4, Pp 249-256 (2017)
institution	DOAJ
collection	DOAJ
language	EN RU
topic	acromegaly cushing disease carbohydrate metabolism disturbances incretins neuropeptides Nutritional diseases. Deficiency diseases RC620-627
spellingShingle	acromegaly cushing disease carbohydrate metabolism disturbances incretins neuropeptides Nutritional diseases. Deficiency diseases RC620-627 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
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.
format	article
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
title	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_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_sort	features of carbohydrate metabolism and incretin secretion in patients with cushing disease and acromegaly
publisher	Endocrinology Research Centre
publishDate	2017
url	https://doaj.org/article/b57c1f2833ba43a49646e293f39890b8
work_keys_str_mv	AT lubovvmatchekhina featuresofcarbohydratemetabolismandincretinsecretioninpatientswithcushingdiseaseandacromegaly AT ekaterinaashestakova featuresofcarbohydratemetabolismandincretinsecretioninpatientswithcushingdiseaseandacromegaly AT zhannaebelaya featuresofcarbohydratemetabolismandincretinsecretioninpatientswithcushingdiseaseandacromegaly AT lyudmilaiastafieva featuresofcarbohydratemetabolismandincretinsecretioninpatientswithcushingdiseaseandacromegaly AT larisavnikankina featuresofcarbohydratemetabolismandincretinsecretioninpatientswithcushingdiseaseandacromegaly AT marinavshestakova featuresofcarbohydratemetabolismandincretinsecretioninpatientswithcushingdiseaseandacromegaly
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Features of carbohydrate metabolism and incretin secretion in patients with Cushing disease and acromegaly

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