Is profound peripheral insulin resistance in patients with pancreatic cancer caused by a tumor-associated factor?

Johan Permert, Thomas E. Adrian, Per Jacobsson, Lennart Jorfelt, A. Brent Fruin, Jörgen Larsson

Research output: Contribution to journalArticlepeer-review

128 Citations (Scopus)

Abstract

Diabetes in patients with pancreatic cancer occurs in 70% to 80% of the patients and is characterized by high plasma levels of insulin. In type II diabetes that is not associated with pancreatic cancer, peripheral insulin resistance and impaired muscle glycogen synthesis are major pathogenic factors. We investigated peripheral insulin sensitivity in patients with pancreatic cancer before and after tumor removal. The effects of pancreatic tumor extracts on glycogen synthesis in skeletal muscle in vitro and the tumor content of pancreatic islet hormones were also investigated. Marked peripheral insulin resistance was found in the patients with pancreatic cancer and was more pronounced in the diabetic patients than in the nondiabetic patients. Insulin sensitivity was not correlated with weight loss, tumor size, or bilirubin levels but improved after surgery. Tumor extracts from diabetic patients with pancreatic cancer caused a marked reduction of glycogen synthesis in skeletal muscle in vitro. All tumors contained islet hormones but not in concentrations sufficient to explain the effect on glycogen synthesis. These findings indicate that a diabetogenic factor associated with pancreatic adenocarcinomas could be involved in the development of the profound peripheral insulin resistance and thereby could contribute to the high incidence of diabetes observed in patients with pancreatic cancer.

Original languageEnglish
Pages (from-to)61-67
Number of pages7
JournalThe American Journal of Surgery
Volume165
Issue number1
DOIs
Publication statusPublished - Jan 1993
Externally publishedYes

ASJC Scopus subject areas

  • Surgery

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