Clinical features of insulin-like growth factor-II producing non-islet-cell tumor hypoglycemia
Clinical features of insulin-like growth factor-II producing non-islet-cell tumor hypoglycemia
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DOI：
10.1016/j.ghir.2006.05.003
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发表时间：
2006-08-01
影响因子：
1.4
通讯作者：
Takano, Kazue
中科院分区：
文献类型：
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作者：
Fukuda, Izumi;Hizuka, Naomi;Takano, Kazue
在一些患有非胰岛细胞肿瘤低血糖症（NICTH）的患者中，来自肿瘤的高分子量IGF-II（大IGF-II）存在于循环中，可能与复发性低血糖症有关。在这项研究中，为了调查IGF-II产生NICTH患者的临床特征，我们分析了78例NICTH患者的病历（男性/女性44/34，年龄62 ± 1.8，范围; 9-86岁）。其血清中含有大量的IGF-II。肝癌和胃癌是最常见的NICTH的原因。肿瘤直径> 10 cm者占70%。79%的患者基础免疫反应性胰岛素（IRI）水平低于3 μ U/dl。65例中31例（48%）以低血糖发作为发病原因，但34例（52%）在低血糖发生前发现肿瘤。47例患者中有25例（53%）血清钾水平降低。这些数据表明，与大肿瘤相关的低胰岛素血症性低血糖支持产生IGF-II的NICTH的诊断。低钾血症与一些患者的低血糖有关。BMI（21.4 +/- 0.6 kg/m2）和血清总蛋白水平（6.6 +/- 0.1 g/dl）在首次低血糖发作时保持不变，表明营养不良可能不是大多数患者低血糖的主要原因。(c)2006爱思唯尔有限公司保留所有权利。
In some patients with non-islet-cell tumor hypoglycemia (NICTH), a high molecular weight form of IGF-II (big IGF-II) derived from tumors is present in the circulation and might be associated with recurrent hypoglycemia. In this study, in order to survey the clinical characteristics of patients with IGF-II producing NICTH, we analyzed the medical records of 78 patients with NICTH (M/F 44/34, age 62 +/- 1.8, range; 9-86 years.) whose serum contained a large amount of big IGF-II. Hepatocellular carcinoma and gastric carcinoma were the most common causes of NICTH. The diameters of the tumors were more than 10 cm in 70% of the patients. Basal immunoreactive insulin (IRI) levels were less than 3 mu U/dl in 79% of the patients. Hypoglycemic attack was the onset of disease in 31 of 65 cases (48%), but the tumor was revealed prior to the occurrence of hypoglycemia in 34 cases (52%). Twenty-five of 47 (53%) patients had decreased serum potassium levels. These data suggested that hypoinsulinemic hypoglycemia associated with the presence of a large tumor supports the diagnosis of IGF-II producing NICTH. Hypokalemia was associated with hypoglycemia in some patients. The BMI (21.4 +/- 0.6 kg/m(2)) and serum total protein levels (6.6 +/- 0.1 g/dl) were preserved at the occurrence of first hypoglycemic attack suggesting that malnutrition might not be the main cause of hypoglycemia in most patients. (c) 2006 Elsevier Ltd. All rights reserved.