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Multiple endocrine neoplasia type 1 (MEN 1) is associated with an increased prevalence of diabetes mellitus and impaired fasting glucose
Author(s) -
McCallum Roland W.,
Parameswaran Venkat,
Burgess John R.
Publication year - 2006
Publication title -
clinical endocrinology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.055
H-Index - 147
eISSN - 1365-2265
pISSN - 0300-0664
DOI - 10.1111/j.1365-2265.2006.02563.x
Subject(s) - medicine , endocrinology , multiple endocrine neoplasia , diabetes mellitus , hyperparathyroidism , primary hyperparathyroidism , impaired glucose tolerance , type 2 diabetes , chromogranin a , gastrinoma , somatostatin , pancreatic polypeptide , gastroenterology , glucagon , insulin , gastrin , biochemistry , chemistry , immunohistochemistry , secretion , gene
Summary Objective Multiple endocrine neoplasia type 1 (MEN 1) is an autosomal dominant syndrome characterized by primary hyperparathyroidism, pituitary neoplasia and foregut lineage neuroendocrine tumours. It has also been associated with premature cardiovascular death. As diabetes is a risk factor for increased cardiovascular mortality we investigated the prevalence and clinical correlates of glycaemic abnormalities in a large MEN 1 kindred. Patients and design The glycaemic status of 72 MEN 1 affected and 133 unaffected members of a single large MEN 1 pedigree was assessed. Fasting glucose results were categorized and compared using WHO criteria. Associations between glycaemic status and MEN 1 phenotype were assessed. Results Thirteen (18·1%) patients with MEN 1 compared to 5 (3·8%) control patients were diabetic ( P < 0·001). Six (8·3%) MEN 1 patients had impaired fasting glucose compared to 4 (3%) of controls ( P < 0·05). Of patients with MEN 1, uncontrolled hypercalcaemia ( P < 0·05) and elevated serum gastrin ( P < 0·05) were more common amongst patients diagnosed with abnormal glycaemia than those with normoglycaemia. There was a nonsignificant trend for elevated chromogranin A, pancreatic polypeptide, gastric inhibitory polypeptide (but not glucagon) and history of bronchopulmonary carcinoid in MEN 1 patients with elevated glycaemia. Conclusions Diabetes and impaired fasting glucose occur significantly more frequently amongst MEN 1 patients than controls and is associated with uncontrolled hyperparathyroidism and evidence of enteropancreatic hyperstimulation.