Gastric emptying of glucose solution and associated plasma concentrations of GLP-1, GIP, and PYY before and after fundoplication
- 161 Downloads
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.
KeywordsGastric emptying Fundoplication GIP GLP-1 PYY
- 5.Elliott RM, Morgan LM, Tredger A, Deacon S, Wright J, Marks V (1993) Glucagon-like peptide-1 (7–37) amide and the glucose-dependent insulinotropic polypeptide secretion in response to nutrient ingestion in man: acute postprandial and 24-h secretion patterns. J Endocrinol 138:159–166CrossRefGoogle Scholar
- 10.Holst JJ, Bersani M (1991) Assays for peptide products of somatostatin gene expression. In Methods in Neurosciences, vol. 5: Neuropeptide Technology, edited by PM Conn. San Diego, CA: Academic Press, pp 322Google Scholar
- 26.Vecht J, Masclee AA, Lamers CB (1997) The dumping syndrome. Current insights into pathophysiology, diagnosis and treatment. Scand J Gastroenterol 223(Suppl):21–27Google Scholar