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Plasma Proinsulin and C‐Peptide Concentrations in Children with Hyperinsulinaemic Hypoglycaemia
Author(s) -
AYNSLEYGREEN A.,
JENKINS P.,
TRONIER B.,
HEDING L. G.
Publication year - 1984
Publication title -
acta pædiatrica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.772
H-Index - 115
eISSN - 1651-2227
pISSN - 0803-5253
DOI - 10.1111/j.1651-2227.1994.tb17748.x
Subject(s) - nesidioblastosis , proinsulin , medicine , endocrinology , insulinoma , c peptide , hyperinsulinism , hypoglycemia , pancreatectomy , adenoma , abnormality , insulin , pancreas , insulin resistance , psychiatry
. Plasma concentrations of proinsulin and C‐peptide were measured in five children presenting with svere hypoglycaemia associated with elevated plasma levels of immunoreactive insulin (IRI) in order to determine whether the profile of circulating B‐cell products related to the underlying pathophysiology of the pancreas. Results were compared with data from 13 normal infants. Four children, three neonates and a nine year old girl, were subjected to partial or total pancreatectomy. The neonates had nesidioblastosis, nesidioblastosis with a microadenoma, and a functional abnormality without histological derangement respectively; the older child had a localised adenoma. The remaining child, a neonate, had transient hypoglycaemia and elevated IRI levels associated with hyperlactataemia and hyperalaninae‐mia. All the children had markedly elevated plasma proinsulin concentrations; the highest levels were seen in the child with an isolated adenoma and in the neonate with nesidioblastosis and a microadenoma. Both of these children also had substantially elevated plasma C‐peptide concentrations. The remaining three neonates had plasma C‐peptide levels, which although in the normal range for normoglycaemia were inappropriately elevated during hypoglycaemia. It is concluded that elevated proinsulin and C‐peptide concentrations are seen in children with hypoglycaemia associated with increased plasma IRI levels and that the profile of the concentrations does not provide a reliable marker for the nature of the underlying pancreatic abnormality.