[Glycoregulation disorders in giant-cell arteritis].
Eight patients with giant cell arteritis (6 with Horton's disease and 2 with polymyalgia rheumatica) were investigated for abnormalities in glycoregulation, previously reported in Horton's disease, using oral glucose tolerance tests with measurement of insulinaemia and C-peptide response to glucagon to evaluate pancreatic function. The results were compared with those obtained in an age and weight matched population of patients with inflammatory syndromes of other origins. All patients with giant cell arteritis had abnormal glucose tolerance tests, with diabetes mellitus in 6 and impaired glucose tolerance in 2. Insulinaemias at all stages of the test, insulin response areas and basal C-peptide values were elevated; C-peptide response to glucagon was normal. Similar results were observed in patients with other inflammatory syndromes. It is concluded that glycoregulation disorders are not incidental in giant cell arteritis, that the normal pancreatic function seems to exclude immune pancreatic vasculitis, and that the abnormal glycoregulation is probably due to insulin-resistance. Since these abnormalities cannot be explained by the patients' advanced age alone, the part played by the inflammatory syndrome, which was common to both groups, is discussed. Its responsibility for inducing insulin-resistance may account for the fact that corticosteroids, which are rapidly effective against giant cell arteritis, normalise oral glucose tolerance tests.
Kitschke
B
B
Rodier
M
M
Ciurana
A J
AJ
Orsetti
A
A
Mirouze
J
J
D000368:Aged; D001786:Blood Glucose / Q000378:metabolism*; D005260:Female; D013700:Giant Cell Arteritis / Q000097:blood* / Q000503:physiopathology; D006801:Humans; D007328:Insulin / Q000378:metabolism; D007333:Insulin Resistance; D000078790:Insulin Secretion; D008297:Male; D008875:Middle Aged; D010179:Pancreas / Q000503:physiopathology; D011111:Polymyalgia Rheumatica / Q000097:blood* / Q000503:physiopathology
D001786:Blood Glucose; D007328:Insulin
Etude des troubles de la glycorégulation dans l'artérite giganto-cellulaire.