1825 INTRAVENOUS GLUCOSE TOLERANCE TEST ASSESSMENT OF GLUCOSE-INSULIN KINETICS FOLLOWING TREATMENT OF THE KIDNEY WITH A SUPRA-MAXIMAL DOSE OF SHOCK WAVES IN A PORCINE MODEL OF METABOLIC SYNDROME

Abstract

INTRODUCTION AND OBJECTIVES: In our continuing efforts to determine whether shock wave lithotripsy (SWL) is a risk factor for the development of diabetes mellitus, we treated the kidney of metabolic syndrome (MetS) pigs with a supra-maximal dose of shock waves (SWs) and assessed the SWL effect on the glucose-insulin kinetic response to an intravenous glucose tolerance test (IVGTT). METHODS: Adult female Ossabaw pigs (9-month-old) were fed an excess calorie atherogenic diet to induce MetS. At 15 months of age, the MetS pigs underwent SWL treatment (4000 SWs, 24 kV at 120 SWs/min using the HM-3 lithotripter; n 7). SWs were targeted to the upper pole calyx of the left kidney because of its close association with the tail of the pancreas?a segment rich in insulin containing -cells. IVGTTs were performed on conscious, fasting MetS pigs before SWL and at 1-month and 2-months post-SWL with frequent blood samples taken for glucose and insulin measurement. RESULTS: Pigs fed an excess calorie atherogenic diet developed features of MetS: obesity, dyslipidemia, insulin resistance and glucose intolerance. Fasting levels of plasma glucose and insulin, as well as their response profile to IVGTTs, were similar before and after SWL. Estimates of insulin resistance, glucose tolerance and pancreatic beta cell function derived from the glucose-insulin kinetics calculated from IVGTTs were not significantly altered following SWL. CONCLUSIONS: The pig?s MetS status was unchanged following overtreatment of the kidney with 4000 high-energy SWs. These findings do not support a single session of SWL in MetS patients as a risk factor for the onset of diabetes mellitus?at least in the short-term.