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Research Article Free access | 10.1172/JCI118435

Hyperproinsulinemia is associated with increased beta cell demand after hemipancreatectomy in humans.

E R Seaquist, S E Kahn, P M Clark, C N Hales, D Porte Jr, and R P Robertson

Department of Medicine, University of Minnesota, Minneapolis 55455, USA.

Find articles by Seaquist, E. in: PubMed | Google Scholar

Department of Medicine, University of Minnesota, Minneapolis 55455, USA.

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Department of Medicine, University of Minnesota, Minneapolis 55455, USA.

Find articles by Clark, P. in: PubMed | Google Scholar

Department of Medicine, University of Minnesota, Minneapolis 55455, USA.

Find articles by Hales, C. in: PubMed | Google Scholar

Department of Medicine, University of Minnesota, Minneapolis 55455, USA.

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Department of Medicine, University of Minnesota, Minneapolis 55455, USA.

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Published January 15, 1996 - More info

Published in Volume 97, Issue 2 on January 15, 1996
J Clin Invest. 1996;97(2):455–460. https://doi.org/10.1172/JCI118435.
© 1996 The American Society for Clinical Investigation
Published January 15, 1996 - Version history
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Abstract

The cause of disproportionate hyperproinsulinemia in patients with type II diabetes is controversial. To examine whether increased beta cell demand might contribute, we measured proinsulin and insulin concentrations in clinically healthy humans who had undergone hemipancreatectomy for the purpose of organ donation, a procedure previously demonstrated to increase beta cell demand and diminish insulin secretory reserve capacity. Subjects were studied at least 1 yr after hemipancreatectomy. Seven donors were followed prospectively and serves as their own controls. Nine additional donors were matched with normal controls (cross-sectional group). Fasting serum concentrations of intact proinsulin and conversion intermediates (total) were measured by a two-step radioimmunoassay; independent determinations of intact proinsulin and 32,33 split proinsulin were performed using an immunoradiometric assay. Serum total proinsulin values were significantly greater in hemipancreatectomized groups than controls (prospective group: predonation = 6.24 +/- 1.14 pM, postdonation = 34.63 +/- 17.47 pM, P < 0.005; cross-sectional group: controls = 5.78 +/- 1.12 pM, donors = 15.22 +/- 5.20 pM, P < 0.025). The ratio of total proinsulin to immunoreactive insulin was directly correlated with fasting plasma glucose and showed a significant inverse relationship to secretory reserve capacity. Both absolute and relative hyperproinsulinemia is found in hemipancreatectomized donors. These data demonstrate that partial pancreatectomy with its associated increase in beta cell demand raises measures of proinsulin in humans.

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