Heterogeneity of proliferative markers in pancreatic β-cells of patients with severe hypoglycemia following Roux-en-Y gastric bypass

Acta Diabetologica
M E PattiRohit N Kulkarni

Abstract

Severe postprandial hypoglycemia with neuroglycopenia is an increasingly recognized, debilitating complication of Roux-en-Y gastric bypass (RYGB) surgery. Increased secretion of insulin and incretin hormones is implicated in its pathogenesis. Histopathologic examination of pancreas has demonstrated increased islet size and/or nuclear diameter in post-RYGB patients who underwent pancreatectomy for severe refractory hypoglycemia with neuroglycopenia (RYGB + NG). We aimed to determine whether β-cell proliferation or apoptosis is altered in RYGB + NG. We performed an observational study to analyze markers of proliferation, apoptosis, cell cycle, and transcription factor expression in pancreatic tissue from affected RYGB + NG patients (n = 12), normoglycemic patients undergoing pancreatic surgery for benign lesions (controls, n = 6), and individuals with hypoglycemia due to insulinoma (n = 52). Proliferative cell nuclear antigen (PCNA) expression was increased in insulin-positive cells in RYGB + NG patients (4.5-fold increase, p < 0.001 vs. controls) and correlated with β-cell mass. Ki-67 immunoreactivity was low in both RYGB + NG and controls, but did not differ between groups. Phospho-histone H3 levels did not differ between RYGB ...Continue Reading

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Citations

Aug 14, 2018·The Journal of Clinical Endocrinology and Metabolism·Marzieh SalehiMary-Elizabeth Patti
May 15, 2019·Current Opinion in Clinical Nutrition and Metabolic Care·Henri Honka, Marzieh Salehi
Nov 13, 2019·The Journal of Clinical Endocrinology and Metabolism·Christopher M MullaMary Elizabeth Patti
Apr 19, 2019·JCI Insight·Ercument DiriceRohit N Kulkarni
Mar 6, 2019·Journal of the Endocrine Society·Annette GeorgiaJudith Korner

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