Abstract
Half of the patients with phaeochromocytoma have glucose intolerance which could be life-threatening as well as causing postoperative hypoglycemia. Glucose intolerance is due to impaired insulin secretion and/or increased insulin resistance. Impaired insulin secretion is caused by stimulating adrenergic α2 receptors of pancreatic β-cells and increased insulin resistance is caused by stimulating adrenergic α1 and β3 receptors in adipocytes, α1 and β2 receptors of pancreatic α-cells and skeletal muscle. Furthermore, different affinities to respective adrenergic receptors exist between epinephrine and norepinephrine. Clinical studies revealed patients with phaeochromocytoma had impaired insulin secretion as well as increased insulin resistance. Furthermore, excess of epinephrine could affect glucose intolerance mainly by impaired insulin secretion and excess of norepinephrine could affect glucose intolerance mainly by increased insulin resistance. Glucose intolerance on paraganglioma could be caused by increased insulin resistance mainly considering paraganglioma produces more norepinephrine than epinephrine. To conclude, the difference of actions between excess of epinephrine and norepinephrine could lead to improve understanding and management of glucose intolerance on phaeochromocytoma.
Highlights
Phaeochromocytoma is a neuroendocrine tumor derived from chromaffin cells in the adrenal medulla that produces catecholamines [1, 2]
Glucose intolerance is known for its hyperglycemia due to impaired glucose homeostasis, which is a result of impaired insulin secretion and/or increased insulin resistance [5, 6]
Wilber and co-workers reported that insulin secretion was inhibited by Glucose Intolerance on Phaeochromocytoma an excess of catecholamine [7]
Summary
Half of the patients with phaeochromocytoma have glucose intolerance which could be lifethreatening as well as causing postoperative hypoglycemia. Glucose intolerance is due to impaired insulin secretion and/or increased insulin resistance. Impaired insulin secretion is caused by stimulating adrenergic a2 receptors of pancreatic b-cells and increased insulin resistance is caused by stimulating adrenergic a1 and b3 receptors in adipocytes, a1 and b2 receptors of pancreatic a-cells and skeletal muscle. Clinical studies revealed patients with phaeochromocytoma had impaired insulin secretion as well as increased insulin resistance. Excess of epinephrine could affect glucose intolerance mainly by impaired insulin secretion and excess of norepinephrine could affect glucose intolerance mainly by increased insulin resistance. Glucose intolerance on paraganglioma could be caused by increased insulin resistance mainly considering paraganglioma produces more norepinephrine than epinephrine.
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