Glucose Intolerance on Phaeochromocytoma and Paraganglioma—The Current Understanding and Clinical Perspectives

Abe, Ichiro; Islam, Farhadul; Lam, Alfred

doi:10.3389/fendo.2020.593780

Cited by 14 publications

(7 citation statements)

References 41 publications

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“…Metabolic disorders in patients with PPGL have been described in previous reports [24][25][26][27][28]. Both impaired insulin secretion and increased insulin resistance have been implicated as underlying causes of glucose homeostasis in PPGL patients [29][30][31].…”

Section: Discussionmentioning

confidence: 84%

Circulating GLP-1 Levels in Patients with Pheochromocytoma/Paraganglioma

Chen

Lai

et al. 2022

International Journal of Endocrinology

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The sympathoadrenal system has been shown to stimulate the secretory activity of enteroendocrine cells, although the response is transient. Our aim was to investigate the effects of long-term catecholamine excess on circulating glucagon-likepeptide-1 (GLP-1) levels in patients with pheochromocytoma/paraganglioma (PPGL). Thirty patients diagnosed with PPGL were analyzed. A significant negative association was observed between fasting plasma GLP-1 levels and elevated plasma-free metanephrine ( r = − 0.407 , p = 0.026 ). After adjustment for age, sex, body mass index (BMI), serum creatinine, and the presence of hyperglycemia, the negative association between plasma GLP-1 and metanephrine persisted by multiple linear regression analysis ( β = − 0.493 , p = 0.013 ). Positive correlations between fasting glucose and plasma metanephrine ( r = 0.380 , p = 0.038 ) and normetanephrine levels ( r = 0.450 , p = 0.013 ) were also found. Mean fasting levels of total GLP-1 increased significantly from 25.81 to 39.01 pmol/L ( p = 0.017 ) after PPGL resection. In conclusion, long-term overproduction of catecholamines appears to induce suppression of GLP-1 production compared to an acute response to a stress stimulus. Further studies are required to elucidate the mechanism of GLP-1 secretion with chronic exposure to catecholamine.

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Section: Discussionmentioning

confidence: 84%

Circulating GLP-1 Levels in Patients with Pheochromocytoma/Paraganglioma

Chen

Lai

et al. 2022

International Journal of Endocrinology

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“…Normetanephrine is a metabolite of norepinephrine produced by the action of catechol-O-methyltransferase. It is a marker for catecholamine-secreting tumors such as pheochromocytoma [ 40 ], which has been studied. It is reported that blood stasis is one of the primary syndromes of pheochromocytoma [ 41 ].…”

Section: Discussionmentioning

confidence: 99%

UPLC-G2Si-HDMS Untargeted Metabolomics for Identification of Yunnan Baiyao’s Metabolic Target in Promoting Blood Circulation and Removing Blood Stasis

Zhang

Wang

2022

Molecules

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Yunnan Baiyao is a famous Chinese patent medicine in Yunnan Province. However, its mechanism for promoting blood circulation and removing blood stasis is not fully explained. Our study used metabonomics technology to reveal the regulatory effect of Yunnan Baiyao on small molecular metabolites in promoting blood circulation and removing blood stasis, and exploring the related urine biomarkers. The coagulation function, blood rheology, and pathological results demonstrated that after Yunnan Baiyao treatment, the pathological indexes in rats with epinephrine hydrochloride-induced blood stasis syndrome improved and returned to normal levels. This is the basis for the effectiveness of Yunnan Baiyao. UPLC-G2Si-HDMS was used in combination with multivariate statistical analysis to conduct metabonomic analysis of urine samples. Finally, using mass spectrometry technology, 28 urine biomarkers were identified, clarifying the relevant metabolic pathways that play a vital role in the Yunnan Baiyao treatment. These were used as the target for Yunnan Baiyao to promote blood circulation and remove blood stasis. This study showed that metabolomics strategies provide opportunities and conditions for a deep and systematic understanding of the mechanism of action of prescriptions.

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“…[29,38] The main reasons for impaired glucose tolerance in PPGL are impaired insulin secretion and increased insulin resistance. [39] Moreover, different catecholamine secretion phenotypes in PPGL have varying effects on impaired glucose tolerance. Abe et al suggested that excessive adrenaline primarily impairs insulin secretion, whereas noradrenaline primarily increases insulin resistance.…”

Section: Catecholamines Enhance Substance Metabolism In Patients With...mentioning

confidence: 99%

Main mechanisms and clinical implications of alterations in energy expenditure state among patients with pheochromocytoma and paraganglioma: A review

Yang,

Zhou,

Zhao

et al. 2024

Medicine

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Pheochromocytoma and paraganglioma (PPGL) are rare neuroendocrine tumors with diverse clinical presentations. Alterations in energy expenditure state are commonly observed in patients with PPGL. However, the reported prevalence of hypermetabolism varies significantly and the underlying mechanisms and implications of this presentation have not been well elucidated. This review discusses and analyzes the factors that contribute to energy consumption. Elevated catecholamine levels in patients can significantly affect substance and energy metabolism. Additionally, changes in the activation of brown adipose tissue (BAT), inflammation, and the inherent energy demands of the tumor can contribute to increased resting energy expenditure (REE) and other energy metabolism indicators. The PPGL biomarker, chromogranin A (CgA), and its fragments also influence energy metabolism. Chronic hypermetabolic states may be detrimental to these patients, with surgical tumor removal remaining the primary therapeutic intervention. The high energy expenditure of PPGL has not received the attention it deserves, and an accurate assessment of energy metabolism is the cornerstone for an adequate understanding and treatment of the disease.

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Glucose Intolerance on Phaeochromocytoma and Paraganglioma—The Current Understanding and Clinical Perspectives

Cited by 14 publications

References 41 publications

Circulating GLP-1 Levels in Patients with Pheochromocytoma/Paraganglioma

Circulating GLP-1 Levels in Patients with Pheochromocytoma/Paraganglioma

UPLC-G2Si-HDMS Untargeted Metabolomics for Identification of Yunnan Baiyao’s Metabolic Target in Promoting Blood Circulation and Removing Blood Stasis

Main mechanisms and clinical implications of alterations in energy expenditure state among patients with pheochromocytoma and paraganglioma: A review

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