The effect of pancreatic polypeptide on glucose disposal after surgical alterations of the pancreas

Henry M. Prillaman, Stephen B. Cox, Arthur E. Freedlender, Gregory E. Cornett, Holly A. Jones, Terry L. Flanagan, Ronald E. Chance, James A. Hoffmann, Dana Andersen, Dariush Elahi, John B. Hanks

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Surgical alterations of the pancreas result in anatomic changes that can affect postoperative glucose metabolism. Pancreas transplantation results in reduction of beta-cell mass, systemic release of insulin, and denervation. The authors hypothesized that such alterations affect peripheral glucose disposal to induce an "insensitivity" to endogenously (systemically) released insulin. Additionally, they hypothesized that surgically induced deficiency of the postprandial hormone, pancreatic polypeptide, might contribute to altered glucose disposal. The authors studied two surgical models in dogs known to be devoid of pancreatic polypeptide - 70% proximal pancreatectomy (PPx) and PPx plus distal pancreas autotransplantation (PAT/B). Oral glucose challenge and euglycemic hyperinsulinemic clamp studies were performed before and after a 16-day "pulsed" infusion of pancreatic polypeptide. Both surgical procedures resulted in elevations in the integrated glucose response after oral glucose, which was not affected by pancreatic polypeptide infusion. Euglycemic clamp studies showed decreased hepatic glucose output (Ra) and overall glucose disposal (Rd) in the fasted state for both surgical groups. The transplant animals demonstrated significant decreases in Rd during the hyperinsulinemic challenge (3.2 ± 0.01 versus 5.7 ± 0.01 mg/kg/minute at 60 to 120 minutes for PAT/B versus control). After 16 days of pancreatic polypeptide infusion, however, basal Ra, as well as basal and 60- to 120-minute Rd values, were returned to control values in the transplant group. The authors conclude that pancreas transplantation results in altered glucose disposal, possibly due to an altered effectiveness of systemically released insulin. They conclude that pancreatic polypeptide is an important modulator of peripheral insulin action. Therefore, the role of pancreatic polypeptide must be taken into account when evaluating postoperative glucose metabolism in canine models of pancreas transplantation.

Original languageEnglish (US)
Pages (from-to)574-582
Number of pages9
JournalAnnals of Surgery
Volume216
Issue number5
StatePublished - 1992
Externally publishedYes

Fingerprint

Pancreatic Polypeptide
Pancreas
Glucose
Pancreas Transplantation
Insulin
Pancreatectomy
Glucose Clamp Technique
Transplants
Anatomic Models
Autologous Transplantation
Denervation
Canidae
Dogs

ASJC Scopus subject areas

  • Surgery

Cite this

Prillaman, H. M., Cox, S. B., Freedlender, A. E., Cornett, G. E., Jones, H. A., Flanagan, T. L., ... Hanks, J. B. (1992). The effect of pancreatic polypeptide on glucose disposal after surgical alterations of the pancreas. Annals of Surgery, 216(5), 574-582.

The effect of pancreatic polypeptide on glucose disposal after surgical alterations of the pancreas. / Prillaman, Henry M.; Cox, Stephen B.; Freedlender, Arthur E.; Cornett, Gregory E.; Jones, Holly A.; Flanagan, Terry L.; Chance, Ronald E.; Hoffmann, James A.; Andersen, Dana; Elahi, Dariush; Hanks, John B.

In: Annals of Surgery, Vol. 216, No. 5, 1992, p. 574-582.

Research output: Contribution to journalArticle

Prillaman, HM, Cox, SB, Freedlender, AE, Cornett, GE, Jones, HA, Flanagan, TL, Chance, RE, Hoffmann, JA, Andersen, D, Elahi, D & Hanks, JB 1992, 'The effect of pancreatic polypeptide on glucose disposal after surgical alterations of the pancreas', Annals of Surgery, vol. 216, no. 5, pp. 574-582.
Prillaman HM, Cox SB, Freedlender AE, Cornett GE, Jones HA, Flanagan TL et al. The effect of pancreatic polypeptide on glucose disposal after surgical alterations of the pancreas. Annals of Surgery. 1992;216(5):574-582.
Prillaman, Henry M. ; Cox, Stephen B. ; Freedlender, Arthur E. ; Cornett, Gregory E. ; Jones, Holly A. ; Flanagan, Terry L. ; Chance, Ronald E. ; Hoffmann, James A. ; Andersen, Dana ; Elahi, Dariush ; Hanks, John B. / The effect of pancreatic polypeptide on glucose disposal after surgical alterations of the pancreas. In: Annals of Surgery. 1992 ; Vol. 216, No. 5. pp. 574-582.
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AU - Freedlender, Arthur E.

AU - Cornett, Gregory E.

AU - Jones, Holly A.

AU - Flanagan, Terry L.

AU - Chance, Ronald E.

AU - Hoffmann, James A.

AU - Andersen, Dana

AU - Elahi, Dariush

AU - Hanks, John B.

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N2 - Surgical alterations of the pancreas result in anatomic changes that can affect postoperative glucose metabolism. Pancreas transplantation results in reduction of beta-cell mass, systemic release of insulin, and denervation. The authors hypothesized that such alterations affect peripheral glucose disposal to induce an "insensitivity" to endogenously (systemically) released insulin. Additionally, they hypothesized that surgically induced deficiency of the postprandial hormone, pancreatic polypeptide, might contribute to altered glucose disposal. The authors studied two surgical models in dogs known to be devoid of pancreatic polypeptide - 70% proximal pancreatectomy (PPx) and PPx plus distal pancreas autotransplantation (PAT/B). Oral glucose challenge and euglycemic hyperinsulinemic clamp studies were performed before and after a 16-day "pulsed" infusion of pancreatic polypeptide. Both surgical procedures resulted in elevations in the integrated glucose response after oral glucose, which was not affected by pancreatic polypeptide infusion. Euglycemic clamp studies showed decreased hepatic glucose output (Ra) and overall glucose disposal (Rd) in the fasted state for both surgical groups. The transplant animals demonstrated significant decreases in Rd during the hyperinsulinemic challenge (3.2 ± 0.01 versus 5.7 ± 0.01 mg/kg/minute at 60 to 120 minutes for PAT/B versus control). After 16 days of pancreatic polypeptide infusion, however, basal Ra, as well as basal and 60- to 120-minute Rd values, were returned to control values in the transplant group. The authors conclude that pancreas transplantation results in altered glucose disposal, possibly due to an altered effectiveness of systemically released insulin. They conclude that pancreatic polypeptide is an important modulator of peripheral insulin action. Therefore, the role of pancreatic polypeptide must be taken into account when evaluating postoperative glucose metabolism in canine models of pancreas transplantation.

AB - Surgical alterations of the pancreas result in anatomic changes that can affect postoperative glucose metabolism. Pancreas transplantation results in reduction of beta-cell mass, systemic release of insulin, and denervation. The authors hypothesized that such alterations affect peripheral glucose disposal to induce an "insensitivity" to endogenously (systemically) released insulin. Additionally, they hypothesized that surgically induced deficiency of the postprandial hormone, pancreatic polypeptide, might contribute to altered glucose disposal. The authors studied two surgical models in dogs known to be devoid of pancreatic polypeptide - 70% proximal pancreatectomy (PPx) and PPx plus distal pancreas autotransplantation (PAT/B). Oral glucose challenge and euglycemic hyperinsulinemic clamp studies were performed before and after a 16-day "pulsed" infusion of pancreatic polypeptide. Both surgical procedures resulted in elevations in the integrated glucose response after oral glucose, which was not affected by pancreatic polypeptide infusion. Euglycemic clamp studies showed decreased hepatic glucose output (Ra) and overall glucose disposal (Rd) in the fasted state for both surgical groups. The transplant animals demonstrated significant decreases in Rd during the hyperinsulinemic challenge (3.2 ± 0.01 versus 5.7 ± 0.01 mg/kg/minute at 60 to 120 minutes for PAT/B versus control). After 16 days of pancreatic polypeptide infusion, however, basal Ra, as well as basal and 60- to 120-minute Rd values, were returned to control values in the transplant group. The authors conclude that pancreas transplantation results in altered glucose disposal, possibly due to an altered effectiveness of systemically released insulin. They conclude that pancreatic polypeptide is an important modulator of peripheral insulin action. Therefore, the role of pancreatic polypeptide must be taken into account when evaluating postoperative glucose metabolism in canine models of pancreas transplantation.

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