title: Severe hyperinsulinemia, decreased GLUT3 and GLUT4 expression, and increased retinol binding protein 4 in a patient with chronic graft-versus-host disease post bone marrow transplantation.
abstract: Hyperinsulinemia with or without DM2 is a frequent long-term sequela of BMT, especially following cGvHD. In this report, an extensive evaluation of a patient with cGvHD is described: glucose and insulin during OGTT, markers of inflammation, adiponectin and RBP4, body composition analysis, and the kinetics of GLUT3 and GLUT4 in circulating monocytes were evaluated. Hyperinsulinemia, associated with partial lipodystrophy, elevated RBP4, low adiponectin levels, and decreased expression of GLUT3 and GLUT4 were detected. The defects disclosed in this particular patient possibly explain, at least in part, the mechanisms underlying insulin resistance in patients undergoing BMT. It is not clear whether insulin resistance was caused by the drugs, the process itself, or the residual damage to the muscles and/or adipose tissue.
authors: First Department of Pediatrics, Athens University Medical School, Athens, Greece.
authors: Sarantis
authors: S
authors: Livadas
authors: Antonis
authors: A
authors: Voutetakis
authors: Jean-Claude
authors: JC
authors: Bourhis
authors: Eirini
authors: E
authors: Maratou
authors: George
authors: G
authors: Dimitriadis
authors: Alexandra
authors: A
authors: Margeli
authors: Helen
authors: H
authors: Chandrinou
authors: Evgenios
authors: E
authors: Goussetis
authors: Ioannis
authors: I
authors: Papassotiriou
authors: Catherine
authors: C
authors: Dacou-Voutetakis
mesh_terms: D052242:Adiponectin / Q000096:biosynthesis; D000273:Adipose Tissue / Q000166:cytology; D000293:Adolescent; D001823:Body Composition; D016026:Bone Marrow Transplantation / Q000379:methods*; D002648:Child; D005786:Gene Expression Regulation; D005951:Glucose Tolerance Test; D051274:Glucose Transporter Type 3 / Q000235:genetics*; D051275:Glucose Transporter Type 4 / Q000235:genetics*; D006086:Graft vs Host Disease / Q000378:metabolism*; D006801:Humans; D006946:Hyperinsulinism / Q000150:complications / Q000378:metabolism*; D007249:Inflammation; D007333:Insulin Resistance; D007700:Kinetics; D008060:Lipodystrophy / Q000378:metabolism; D008297:Male; D009000:Monocytes / Q000166:cytology; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000150:complications / Q000628:therapy*; D054839:Retinol-Binding Proteins, Plasma / Q000096:biosynthesis*
chemical_list: D052242:Adiponectin; D051274:Glucose Transporter Type 3; D051275:Glucose Transporter Type 4; C101326:RBP4 protein, human; D054839:Retinol-Binding Proteins, Plasma; C495687:SLC2A3 protein, human; C495692:SLC2A4 protein, human