Serum ferritin in healthy subjects and type 2 diabetic patients

In order to study the relationship between the serum ferritin level and the components of the insulin resistance syndrome in type 2 diabetic patients, we evaluated fifty type 2 diabetic patients who were selected according to NDDG/WHO criteria from those patients attending Korea University Hospital from 1997 to 1998. Twenty-five healthy non-diabetic subjects of comparable age and sex distribution acted as a control group. The results showed that the value of log ferritin was higher in the type 2 diabetes patients than the control subjects, but not at a statistically significant level (p = 0.09). Log ferritin was correlated with fasting blood sugar level (r = 0.235, p = 0.048) and body mass index (BMI) (r = 0.285, p = 0.05). In the type 2 diabetic patients, log ferritin was correlated with fasting C-peptide (r = 0.478, p = 0.009). In the control subjects, log ferritin was correlated only with BMI (r = 0.477, p = 0.012). In a stepwise multiple regression analysis, the diabetic group showed a significant correlation between fasting C-peptide and log ferritin (p = 0.001). In the control group, the fasting sugar level was significantly correlated with log ferritin (p = 0.034). These results suggest that serum ferritin can be employed as a marker of not only glucose homeostasis but also insulin resistance both in type 2 diabetic and control subjects.

Serum insulin, proinsulin, and proinsulin/insulin ratio in type 2 diabetic patients / 대한내과학회지

BACKGROUND: Although insulin resistance and decreased insulin secretion are characteristics of establised type 2 DM, which of these metabolic abnormalities is the primary determinant of type 2 DM is controversial. It is also not well known how insulin resistance and beta cell dysfunction influence serum insulin, proinsulin, proinsulin/insulin ratio in type 2 DM. METHODS: We compared serum insulin, proinsulin, proinsulin/insulin ratio in type 2 diabetic patients and control subjects. We investigated the relationship between serum insulin, proinsulin, proinsuolin/insulin ratio and several biochemical markers which represent insulin resistance or beta cell function. RESULTS: Proinsulin, total insulin, and proinsulin/insulin ratio were significantly higher in type 2 DM than control(p< 0.001). In diabetic patients, proinsulin was correlated with fasting c-peptide(r=0.43, p=0.002), postprandial 2 hour blood glucose(r=0.213, p=0.05), and triglyceride(r=0.28, p=0.022). Total insulin was correlated with urinary albumin excretion rates(r=0.224, p=0.025) and body mass index(r=0.269, p=0.014). Proinsulin/insulin ratio was positively correlated with fasting c-peptide(r=0.236, p=0.031), fasting blood glucose(r=0.264, p=0.015), postprandial 2 hour blood glucose(r=0.277, p=0.001), and triglyceride(r=0.428, p< 0.001). In control subjects, fasting insulin was correlated with triglyceride (r=0.366, p=0.002). Proinsulin/insulin ratio was correlated with age(r=0.241, p=0.044). CONCLUSION: The serum levels of insulin and proinsulin seems to be associated with several markers of insluin resistance. The proinsulin/insulin ratio might represent beta cell function rather than insulin resistance. But more studies are needed to clarify the mechanism of elevated proinsulin/insulin ratio in type 2 DM.

A Case of Insulinoma which was treated by Laparoscopic Enucleation / 대한내분비학회지

Insulinoma is a functional endocrine tumor arising from the beta cells of islets of Langerhans of pancreas. The only effective treatment of insulinoma was surgical removal of the tumor. Recently, laparoscopic surgery for islet cell tumors of the pancreas is introduced. Laparoscopic enucleation or resection of benign islet tumors results in a shorter hospital recovery and is a good alternative to open surgery We report a case of insulinoma that was treated sucessfully by laparoscopic enucleation.

A Case of Parathyroid Cancer with a Local Metastatic Focus Revealed by 99mTc-sestamibi scan / 대한내분비학회지

Carcinoma of the parathyroid gland is rare, comprising only 0.1% to 5% of all patients with primary hyperparathyroidism. It presents with severe hypercalcemia, bone disease, palpable neck mass, renal involvement and etc. Since the initial operation offers the best chance for cure, preoperative localization and intraoperative recognition of parathyroid cancer are essential. Recently parathyroid imaging has been described with 99mTc-sestamibi as an alternative to 201Tl. This newer agent has many physical and dosirnetric advantages and represents higher detection sensitivity than 201Tl-99mTc subtraction scan. We experienced a 41-year-old man presenting with recurrent hyperparathyroidism in spite of 2 previous operations. In preoperative localization, there was no abnormal uptake in 201Tl-99mTc subtraction scan but 99mTc-sestamibi scan revealed metastatic foci on right cervical area. He was successfully treated with modified radical neck dissection.