Open AccessSerum chromogranin A level continuously rises with the progression of type 1 diabetes, and indicates the presence of both enterochromaffin‐like cell hyperplasia and autoimmune gastritis
Author(s) -
Herold Zoltan,
Herold Magdolna,
Nagy Peter,
Patocs Attila,
Doleschall Marton,
Somogyi Aniko
Publication year - 2020
Publication title -
journal of diabetes investigation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.089
H-Index - 50
eISSN - 2040-1124
pISSN - 2040-1116
DOI - 10.1111/jdi.13203
Subject(s) - medicine , chromogranin a , gastroenterology , glycated hemoglobin , hyperplasia , diabetes mellitus , gastrin , type 2 diabetes , atrophic gastritis , enterochromaffin cell , gastritis , atypical hyperplasia , billroth i , endocrinology , helicobacter pylori , cancer , gastrectomy , immunohistochemistry , receptor , serotonin , secretion
Aims/Introduction The relationship of chromogranin A (CgA) levels above the normal range with various outcomes, such as glycated hemoglobin levels, enterochromaffin‐like cell hyperplasia and autoimmune gastritis, was investigated in type 1 diabetes patients with special regard to the progression of comorbidities. Materials and Methods A cohort study on 153 type 1 diabetes patients was carried out with a prospective branch on clinical and laboratory data, and a retrospective branch on histological data obtained by gastroscopy. Results Patients with CgA levels above the upper limit of the normal range ( n = 28) had significantly higher glycated hemoglobin levels ( P = 0.0160) than those with CgA in the normal range ( n = 125). The correlation between CgA and glycated hemoglobin was significant ( P < 0.0001), but weak ( R = +0.32). A slight, but steady elevation ( P = 0.0410) in CgA level was observed to co‐vary with the duration of type 1 diabetes. Enterochromaffin‐like cell hyperplasia and autoimmune gastritis was significantly more frequent ( P = 0.0087 for both) in the high CgA group. Detailed analyses on gastric tissue samples confirmed a progression of enterochromaffin‐like cell hyperplasia ( P = 0.0192) accompanied by CgA elevation ( P = 0.0316). Conclusions The early detection and follow up of the later progression of enterochromaffin‐like cell hyperplasia and autoimmune gastritis into gastric neuroendocrine tumors, which have ~100‐fold greater incidence in type 1 diabetes patients, can be achieved by assessment of CgA levels. Therefore, the use of CgA could be considered as a novel auxiliary biomarker in the care of these type 1 diabetes complications.