Diagnostic Performance of 48-Hour Fasting Test and Insulin Surrogates in Patients with Suspected Insulinoma

Keijiro Ueda, Ken Kawabe, Lingaku Lee, Yuichi Tachibana, Nao Fujimori, Hisato Igarashi, Yoshinao Oda, Robert T. Jensen, Ryoichi Takayanagi, Tetsuhide Ito

研究成果: ジャーナルへの寄稿記事

1 引用 (Scopus)

抄録

Objectives This study aimed to evaluate the usefulness of the 48-hour fasting test and insulin surrogates followed by a glucagon stimulatory test (GST) for the diagnosis of insulinoma. Methods Thirty-five patients with suspected insulinoma who underwent 48-hour fasting test and GST were retrospectively included in our study: 15 patients with surgically proven insulinomas and 20 patients in whom insulinoma was clinically ruled out. We determined the duration of the fasting test, plasma glucose levels, serum levels of immunoreactive insulin and C-peptide, and insulin surrogates (serum levels of β-hydroxybutyrate, free fatty acid, and response of plasma glucose to intravenous glucagon [ΔPG]) at the end of the fast. Results The sensitivity and specificity of the 48-hour fasting test were 100.0% and 80.0%, respectively, for the diagnosis of insulinoma. When the 48-hour fasting test and immunoreactive insulin, C-peptide, or insulin surrogates were combined, the combination with GST showed the best results. The sensitivity, specificity, and accuracy rate were 93.3%, 95.0%, and 94.3%, respectively, with 1 false-negative case and 1 false-positive case occurring. Conclusions A more accurate and less invasive diagnosis of insulinoma was possible by combining the 48-hour fasting test with the GST, compared with the existing method.

元の言語英語
ページ(範囲)476-481
ページ数6
ジャーナルPancreas
46
発行部数4
DOI
出版物ステータス出版済み - 4 1 2017

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Insulinoma
Fasting
Glucagon
Insulin
C-Peptide
Hydroxybutyrates
Glucose
Sensitivity and Specificity
Serum
Nonesterified Fatty Acids

All Science Journal Classification (ASJC) codes

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Hepatology
  • Endocrinology

これを引用

Diagnostic Performance of 48-Hour Fasting Test and Insulin Surrogates in Patients with Suspected Insulinoma. / Ueda, Keijiro; Kawabe, Ken; Lee, Lingaku; Tachibana, Yuichi; Fujimori, Nao; Igarashi, Hisato; Oda, Yoshinao; Jensen, Robert T.; Takayanagi, Ryoichi; Ito, Tetsuhide.

:: Pancreas, 巻 46, 番号 4, 01.04.2017, p. 476-481.

研究成果: ジャーナルへの寄稿記事

Ueda, K, Kawabe, K, Lee, L, Tachibana, Y, Fujimori, N, Igarashi, H, Oda, Y, Jensen, RT, Takayanagi, R & Ito, T 2017, 'Diagnostic Performance of 48-Hour Fasting Test and Insulin Surrogates in Patients with Suspected Insulinoma', Pancreas, 巻. 46, 番号 4, pp. 476-481. https://doi.org/10.1097/MPA.0000000000000772
Ueda, Keijiro ; Kawabe, Ken ; Lee, Lingaku ; Tachibana, Yuichi ; Fujimori, Nao ; Igarashi, Hisato ; Oda, Yoshinao ; Jensen, Robert T. ; Takayanagi, Ryoichi ; Ito, Tetsuhide. / Diagnostic Performance of 48-Hour Fasting Test and Insulin Surrogates in Patients with Suspected Insulinoma. :: Pancreas. 2017 ; 巻 46, 番号 4. pp. 476-481.
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AU - Igarashi, Hisato

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AB - Objectives This study aimed to evaluate the usefulness of the 48-hour fasting test and insulin surrogates followed by a glucagon stimulatory test (GST) for the diagnosis of insulinoma. Methods Thirty-five patients with suspected insulinoma who underwent 48-hour fasting test and GST were retrospectively included in our study: 15 patients with surgically proven insulinomas and 20 patients in whom insulinoma was clinically ruled out. We determined the duration of the fasting test, plasma glucose levels, serum levels of immunoreactive insulin and C-peptide, and insulin surrogates (serum levels of β-hydroxybutyrate, free fatty acid, and response of plasma glucose to intravenous glucagon [ΔPG]) at the end of the fast. Results The sensitivity and specificity of the 48-hour fasting test were 100.0% and 80.0%, respectively, for the diagnosis of insulinoma. When the 48-hour fasting test and immunoreactive insulin, C-peptide, or insulin surrogates were combined, the combination with GST showed the best results. The sensitivity, specificity, and accuracy rate were 93.3%, 95.0%, and 94.3%, respectively, with 1 false-negative case and 1 false-positive case occurring. Conclusions A more accurate and less invasive diagnosis of insulinoma was possible by combining the 48-hour fasting test with the GST, compared with the existing method.

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