{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T13:34:23Z","timestamp":1787751263831,"version":"build-2784847793"},"reference-count":40,"publisher":"Georg Thieme Verlag KG","issue":"10","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Exp Clin Endocrinol Diabetes"],"published-print":{"date-parts":[[2022,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Objective Insulinoma is a rare tumor of the pancreas that can lead to\n                    spontaneous hypoglycemia due to excessive insulin secretion. Seventy-two-hour\n                    fast is the gold standard for finding the correct diagnosis. Endoscopic\n                    ultrasound (EUS) is an established examination method to identify the\n                    suspicious lesion. Previous studies correlate the measured size of insulinoma\n                    and their endocrine behavior. This study was designed to find a relation between\n                    these variables.<\/jats:p><jats:p>\n          Methods We took the data of patients who had a histologically confirmed\n                    insulinoma after receiving an endoscopic ultrasound in our department. Size and\n                    echogenicity were correlated with the endpoint of the 72-hour fast and hormone\n                    levels.<\/jats:p><jats:p>\n          Results A total of 45 patients were identified. Most insulinomas were\n                    small with a volume of&lt;2 cm3 (median 1.15 cm3).\n                    There was no correlation between the duration of fasting, hormone levels, and\n                    the size of the insulinoma. In addition, in a subgroup analysis, no connection\n                    could be established between the size of the insulinoma and the amount of\n                    insulin released after oral glucose exposure. We found that homogeneous tumors\n                    were significantly smaller and had a lower Ki-67 index. Furthermore, there was a\n                    tendency towards a shorter duration for the 72-hour fast for the small\n                    tumors.<\/jats:p><jats:p>\n          Discussion This data suggests that the measured size of insulinoma by EUS\n                    is not related to the time until termination of the 72-hour fast and measured\n                    hormone levels. The echogenicity seems more important, showing that homogenous\n                    tumors are an indicator of a higher differentiation, which can result in a\n                    shorter duration of the fasting period. The differences in the secretion\n                    behavior of the insulinomas could complicate the correlation of size and the\n                    72-hour fast period.<\/jats:p>","DOI":"10.1055\/a-1840-7492","type":"journal-article","created":{"date-parts":[[2022,5,2]],"date-time":"2022-05-02T23:08:16Z","timestamp":1651532896000},"page":"687-692","source":"Crossref","is-referenced-by-count":5,"title":["Is the Size of Insulinoma Predictive for its Endocrine Behavior?\n                        An Endoscopic Ultrasound Study"],"prefix":"10.1055","volume":"130","author":[{"given":"Jan","family":"Adelmeyer","sequence":"additional","affiliation":[{"name":"Center for Endocrinology, Diabetology & Osteology of\n                    Philipps-University Marburg 35037 Marburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Franziska","family":"G\u00f6bel","sequence":"additional","affiliation":[{"name":"Center for Endocrinology, Diabetology & Osteology of\n                    Philipps-University Marburg 35037 Marburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter Herbert","family":"Kann","sequence":"additional","affiliation":[{"name":"Center for Endocrinology, Diabetology & Osteology of\n                    Philipps-University Marburg 35037 Marburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2022,6,24]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"753","DOI":"10.1016\/j.bpg.2005.06.002","article-title":"Endocrine tumours of the pancreas","volume":"19","author":"K Oberg","year":"2005","journal-title":"Best Pract Res Clin Gastroenterol"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"229","DOI":"10.2217\/fon.09.165","article-title":"Insulinoma: Pathophysiology, localization and management","volume":"6","author":"J J Shin","year":"2010","journal-title":"Future Oncol"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"183","DOI":"10.1159\/000098010","article-title":"Well-differentiated pancreatic tumor\/carcinoma: Insulinoma","volume":"84","author":"W W de Herder","year":"2006","journal-title":"Neuroendocrinology"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"98","DOI":"10.1159\/000335591","article-title":"ENETS Consensus Guidelines for the management of patients with digestive\n                    neuroendocrine neoplasms: Functional pancreatic endocrine tumor syndromes","volume":"95","author":"R T Jensen","year":"2012","journal-title":"Neuroendocrinology"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"783","DOI":"10.1016\/j.bpg.2005.05.008","article-title":"Insulinoma","volume":"19","author":"C S Grant","year":"2005","journal-title":"Best Pract Res Clin Gastroenterol"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"709","DOI":"10.1210\/jc.2008-1410","article-title":"Evaluation and management of adult hypoglycemic disorders: An Endocrine Society\n                    Clinical Practice Guideline","volume":"94","author":"P E Cryer","year":"2009","journal-title":"J Clin Endocrinol Metab"},{"key":"ref7","first-page":"583","volume-title":"Practice guideline neuroendocrine tumors. In: AWMF online - Das Portal der\n                    wissenschaftlichen Medizin","author":"A Rinke","year":"2018"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"941","DOI":"10.1055\/s-2004-823060","article-title":"Diagnosis and surgical treatment of insulinoma-experiences in 40 cases","volume":"129","author":"V Fendrich","year":"2004","journal-title":"Dtsch Med Wochenschr"},{"key":"ref9","first-page":"1302","article-title":"Insulinomas: From diagnosis to treatment. A review of the literature","volume":"25","author":"D Giannis","year":"2020","journal-title":"J BUON"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"6129","DOI":"10.1210\/jc.2019-01204","article-title":"Surgical management, preoperative tumor localization, and histopathology of 80\n                    patients operated on for insulinoma","volume":"104","author":"M Andreassen","year":"2019","journal-title":"J Clin Endocrinol Metab"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"415","DOI":"10.1016\/j.ejim.2014.02.011","article-title":"Approach to the patient with spontaneous hypoglycemia","volume":"25","author":"P Martens","year":"2014","journal-title":"Eur J Intern Med"},{"key":"ref12","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1007\/s11428-012-0914-1","article-title":"Spontanhypoglyk\u00e4mien","volume":"9","author":"M A Nauck","year":"2013","journal-title":"Diabetologe"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"923","DOI":"10.4158\/EP171872.OR","article-title":"Anthropometric features are not predictive of 72-hour fast duration in\n                    insulinomas","volume":"23","author":"D Donegan","year":"2017","journal-title":"Endocr Pract"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"67","DOI":"10.1111\/cen.12777","article-title":"Clinical presentation in insulinoma predicts histopathological tumour\n                    characteristics","volume":"83","author":"P Wolf","year":"2015","journal-title":"Clin Endocrinol (Oxf)"},{"key":"ref15","doi-asserted-by":"crossref","first-page":"252","DOI":"10.5127\/jep.013611","article-title":"Using bootstrap estimation and the plug-in principle for clinical Psychology\n                    Data","volume":"2","author":"D B Wright","year":"2011","journal-title":"J Exp Psychopathol"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"546","DOI":"10.1007\/s00063-006-1064-2","article-title":"Endoscopic ultrasound imaging in neuroendocrine pancreatic tumors. A critical\n                    analysis","volume":"101","author":"P H Kann","year":"2006","journal-title":"Med Klin (Munich)"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"6817","DOI":"10.3748\/wjg.v22.i30.6817","article-title":"Management of gastric and duodenal neuroendocrine tumors","volume":"22","author":"Y Sato","year":"2016","journal-title":"World J Gastroenterol"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"24","DOI":"10.1159\/000381981","article-title":"Biochemical testing in patients with neuroendocrine tumors","volume":"44","author":"D Granberg","year":"2015","journal-title":"Front Horm Res"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"829","DOI":"10.3748\/wjg.v19.i6.829","article-title":"Diagnosis and management of insulinoma","volume":"19","author":"T Okabayashi","year":"2013","journal-title":"World J Gastroenterol"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"265","DOI":"10.1016\/j.ijscr.2012.11.019","article-title":"Giant pancreatic insulinoma. The bigger the worse? Report of two cases and\n                    literature review","volume":"4","author":"B Ielpo","year":"2013","journal-title":"Int J Surg Case Rep"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"575","DOI":"10.1210\/jc.2004-0825","article-title":"Giant insulinoma: Case report and review of the literature","volume":"90","author":"E A Mittendorf","year":"2005","journal-title":"J Clin Endocrinol Metab"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"133","DOI":"10.1007\/s11154-018-9464-1","article-title":"Is endoscopic ultrasonography more sensitive than magnetic resonance imaging in\n                    detecting and localizing pancreatic neuroendocrine tumors?","volume":"19","author":"P H Kann","year":"2018","journal-title":"Rev Endocr Metab Disord"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"1440","DOI":"10.1007\/s00268-017-4317-8","article-title":"Preoperative imaging overestimates the tumor size in pancreatic neuroendocrine\n                    neoplasms associated with multiple endocrine neoplasia type 1","volume":"42","author":"V Polenta","year":"2018","journal-title":"World J Surg"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"471","DOI":"10.1055\/s-2005-865752","article-title":"Endoscopic ultrasound imaging of insulinomas: Limitations and clinical\n                    relevance","volume":"113","author":"P H Kann","year":"2005","journal-title":"Exp Clin Endocrinol Diabetes"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"526","DOI":"10.1007\/s11102-011-0362-8","article-title":"ACTH-secreting pituitary adenomas: Size does not correlate with hormonal\n                    activity","volume":"15","author":"N Mathioudakis","year":"2012","journal-title":"Pituitary"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"1175","DOI":"10.2214\/ajr.165.5.7572498","article-title":"Islet cell tumors of the pancreas: Pathologic-imaging correlation among size,\n                    necrosis and cysts, calcification, malignant behavior, and functional\n                    status","volume":"165","author":"P C Buetow","year":"1995","journal-title":"AJR Am J Roentgenol"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"918","DOI":"10.1007\/s00268-007-9450-3","article-title":"Differentiation of insulin secretion patterns in insulinoma","volume":"32","author":"C Saddig","year":"2008","journal-title":"World J Surg"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"3543","DOI":"10.2337\/db15-0527","article-title":"Human insulinomas show distinct patterns of insulin secretion in vitro","volume":"64","author":"J C Henquin","year":"2015","journal-title":"Diabetes"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"109","DOI":"10.7326\/0003-4819-121-2-199407150-00005","article-title":"Glucose transporter proteins in human insulinoma","volume":"121","author":"G Boden","year":"1994","journal-title":"Ann Intern Med"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"1249","DOI":"10.1007\/s00424-020-02383-4","article-title":"Glucose transporters in pancreatic islets","volume":"472","author":"C Berger","year":"2020","journal-title":"Pflugers Arch"},{"key":"ref31","doi-asserted-by":"publisher","first-page":"4733","DOI":"10.1210\/jc.2006-1430","article-title":"Insulinomas may present with normoglycemia after prolonged fasting but\n                    glucose-stimulated hypoglycemia","volume":"91","author":"P Kar","year":"2006","journal-title":"J Clin Endocrinol Metab"},{"key":"ref32","doi-asserted-by":"publisher","first-page":"832","DOI":"10.1007\/BF03346277","article-title":"Hypoglycemia in response to glucose and glucagon in insulinoma patients with a\n                    negative prolonged fast: Functional and morphological properties","volume":"27","author":"P Wiesli","year":"2004","journal-title":"J Endocrinol Invest"},{"key":"ref33","doi-asserted-by":"publisher","first-page":"1533","DOI":"10.1007\/s10620-020-06379-z","article-title":"Using the secretion ratios of insulin and C-peptide during the 2-h oral glucose\n                    tolerance test to diagnose insulinoma","volume":"66","author":"J Liao","year":"2021","journal-title":"Dig Dis Sci"},{"key":"ref34","doi-asserted-by":"publisher","first-page":"R37","DOI":"10.1530\/EJE-16-1062","article-title":"Management of endocrine disease: Pathogenesis and management of\n                    hypoglycemia","volume":"177","author":"N E Kittah","year":"2017","journal-title":"Eur J Endocrinol"},{"key":"ref35","doi-asserted-by":"publisher","first-page":"E651","DOI":"10.1152\/ajpendo.1989.256.5.E651","article-title":"Insulin, glucagon, and catecholamines in prevention of hypoglycemia during\n                    fasting","volume":"256","author":"P J Boyle","year":"1989","journal-title":"Am J Physiol"},{"key":"ref36","doi-asserted-by":"publisher","first-page":"29","DOI":"10.3389\/fendo.2016.00029","article-title":"Hyperinsulinemic hypoglycemia - The molecular mechanisms","volume":"7","author":"A Nessa","year":"2016","journal-title":"Front Endocrinol (Lausanne)"},{"key":"ref37","doi-asserted-by":"publisher","first-page":"788","DOI":"10.1210\/jcem-72-4-788","article-title":"Deficient counterregulatory hormone responses during hypoglycemia in a patient\n                    with insulinoma","volume":"72","author":"M R Davis","year":"1991","journal-title":"J Clin Endocrinol Metab"},{"key":"ref38","doi-asserted-by":"publisher","first-page":"e00098","DOI":"10.1002\/edm2.98","article-title":"Prolonged plasma glucose elevation on oral glucose tolerance test in young\n                    healthy Japanese individuals","volume":"3","author":"H Ishigaki","year":"2020","journal-title":"Endocrinol Diabetes Metab"},{"key":"ref39","doi-asserted-by":"publisher","first-page":"209","DOI":"10.1530\/EJE-07-0117","article-title":"Preoperative diagnosis of insulinoma: Low body mass index, young age, and female\n                    gender are associated with negative imaging by endoscopic ultrasound","volume":"157","author":"P H Kann","year":"2007","journal-title":"Eur J Endocrinol"},{"key":"ref40","doi-asserted-by":"publisher","first-page":"1144","DOI":"10.1056\/NEJM199504273321707","article-title":"Hypoglycemic disorders","volume":"332","author":"F J Service","year":"1995","journal-title":"N Engl J Med"}],"container-title":["Experimental and Clinical Endocrinology &amp; Diabetes"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-1840-7492.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,10,19]],"date-time":"2022-10-19T00:15:04Z","timestamp":1666138504000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-1840-7492"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,5,2]]},"references-count":40,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2022,10,18]]},"published-print":{"date-parts":[[2022,10]]}},"URL":"https:\/\/doi.org\/10.1055\/a-1840-7492","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0947-7349","1439-3646"],"issn-type":[{"value":"0947-7349","type":"print"},{"value":"1439-3646","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2022,5,2]]},"published":{"date-parts":[[2022,5,2]]}}}