Eur J Endocrinol
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DOI: 10.1530/eje.0.1340320
European Journal of Endocrinology, Vol 134, Issue 3, 320-325
Copyright © 1996 by European Society of Endocrinology
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Increased plasma levels of islet amyloid polypeptide in patients with primary hyperparathyroidism

Stig Valdemarsson, Arnold Leckström, Per Westermark and Anders Bergenfelz

Valdemarsson S, Leckström A, Westermark P, Bergenfelz A. Increased plasma levels of islet amyloid polypeptide in patients with primary hyperparathyroidism. Eur J Endocrinol 1996;134:320–5. ISSN 0804–4643

Amylin, also named islet amyloid polypeptide (IAPP), is a protein that is processed and released from pancreatic β-cells in parallel with insulin. Islet amyloid polypeptide is currently studied with regard to a role for insulin resistance in non-insulin-dependent diabetes. To elucidate a possible function of IAPP for impaired glucose tolerance in primary hyperparathyroidism (pHPT), we studied plasma IAPP levels during an oral glucose tolerance test (OGTT) in seven pHPT patients before and 8 weeks after surgery and in six healthy subjects. The β-glucose level of the patient groups was 4.34 ± 0.12 mmol/l before and 3.97 ± 0.16 mmol/l after surgery (NS), while the serum level of insulin was significantly higher before (16.9 ± 2.8 mIU/l) than after (8.9 ± 1.9 mIU/l) the operation (p < 0.05), indicating a moderately increased insulin resistance in pHPT. The basal plasma levels of IAPP were significantly higher in pHPT patients before than 8 weeks after surgery (9.71 ± 1.05 and 4.30 ± 0.82 pmol/l, respectively; p < 0.01). When compared to the plasma IAPP level of the controls at 1.80 ± 0.38 pmol/l, pHPT patients had higher IAPP values both before (p < 0.01) and at 8 weeks after (p < 0.05) operation, There was a significant correlation between the serum levels of insulin and plasma levels of IAPP in pHPT patients before (r = 0.87, p < 0.01) as wells as 8 weeks after surgery (r = 0.69, p < 0.05). The area under the curve for IAPP during OGTT in pHPT patients was 1872.4 ± 187.7 pmol·min/l, which is significantly higher than after surgery 1010.8 ± 93.7 pmol· min/l) (p < 0.05) and compared to the area for the controls at 840.3 ± 49.9 pmol min/l (p< 0.01). In conclusion, pHPT is associated with an increased plasma level of IAPP, correlated to the serum insulin level, but persistently higher than in controls also 8 weeks after surgery. Possibly, increased IAPP levels can have a role for impaired glucose tolerance in pHPT. The hyperparathyroid state might have a specific role for the release of this peptide, otherwise closely connected to insulin secretion.

Stig Valdemarsson, Department of Internal Medicine, Lund University Hospital, S-221 85 Lund, Sweden






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