Surgical Endoscopy

, Volume 21, Issue 2, pp 309–314 | Cite as

Gastric emptying of glucose solution and associated plasma concentrations of GLP-1, GIP, and PYY before and after fundoplication

  • J. MiholicEmail author
  • M. Hoffmann
  • J.J. Holst
  • J. Lenglinger
  • M. Mittlböck
  • H. Bergmann
  • G. Stacher



This study was designed to assess the relationship between gastric emptying of glucose solution and the ensuing plasma concentrations of glucagon-like peptide-1 (GLP-1), peptide YY (PYY), and glucose-dependent insulinotropic polypeptide (GIP) in patients having undergone fundoplication for gastroesophageal reflux (GERD).

Subjects and methods

In 10 male patients the emptying of 50% glucose solution was determined scintigraphically and its relationship with plasma glucose, GLP-1, PYY, and GIP concentrations was studied before and 3 months after fundoplication.


In the first 30 min after glucose ingestion, emptying was significantly (p = 0.048) faster after fundoplication than before. Emptying and GLP-1 and GIP correlated: the faster the emptying during the first 30 min the greater the concentrations integrated over that period (p = 0.04; p = 0.01; p = 0.02). Emptying and PYY concentrations were unrelated. In the 120–180 min. period, blood glucose concentrations were lower the faster the emptying in the initial 30 min (p = 0.06) and the entire 50-min recording period (p = 0.03) had been. The GLP-1 concentrations integrated over the first 30 min correlated inversely with the integrated plasma glucose during the third hour after ingestion (p = 0.004).


After fundoplication, gastric emptying may, if accelerated in its initial phases, give rise to greater and earlier increases in plasma glucose, GLP-1, and GIP concentrations and thus to reactive hypoglycemia.


Gastric emptying Fundoplication GIP GLP-1 PYY 


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Copyright information

© Springer Science+Business Media, Inc. 2007

Authors and Affiliations

  • J. Miholic
    • 1
    Email author
  • M. Hoffmann
    • 2
  • J.J. Holst
    • 3
  • J. Lenglinger
    • 4
  • M. Mittlböck
    • 1
  • H. Bergmann
    • 5
  • G. Stacher
    • 1
  1. 1.Division of General SurgeryMedical University of ViennaViennaAustria
  2. 2.Department of Nuclear MedicineMedical University of ViennaViennaAustria
  3. 3.Department of Medical PhysiologyPanum Institute, University of CopenhagenCopenhagenDenmark
  4. 4.Psychophysiology Unit at the Department of SurgeryMedical University of ViennaViennaAustria
  5. 5.Department of Biomedical EngineeringMedical University of ViennaViennaAustria

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