Skip to main content
SpringerLink
Log in

Effect of intravenous glucose on intravenous amino acid-induced gallbladder contraction and CCK secretion

  • Originals Articles
  • Published:
Digestive Diseases and Sciences Aims and scope Submit manuscript

Abstract

The present study was undertaken to investigate the effect of acute hyperglycemia on the gallbladder contraction induced by intravenous administration of high doses of amino acids (Vamin 18, 250 mg protein/kg/hr). Six healthy volunteers were studied in random order on two occasions during normoglycemia and hyperglycemia with blood glucose levels stabilized at 15 mmol/liter. Gallbladder volumes, measured with ultrasonography, were studied for 60 min before and for 120 min during intravenous infusion of amino acids (IVAA). Administration of IVAA resulted in a significant reduction (P<0.05) in gallbladder volume from 32±5 cm3 to 17±2 cm3 during normolgycemia. During hyperglycemia no significant changes in gallbladder volume were observed in response to IVAA. No significant changes in plasma CCK concentration, the major hormonal stimulus for gallbladder contraction, occurred in response to IVAA. During hyperglycemia, pancreatic polypeptide (PP) secretion, as an indirect measure of vagal cholinergic tone, in response to IVAA was significantly (P<0.05) reduced compared to normoglycemia. It is concluded that: (1) administration of high doses of IVAA results in significant gallbladder contraction, (2) high doses of IVAA do not stimulate CCK secretion, (3) acute hyperglycemia inhibits IVAA-induced gallbladder contraction, and (4) acute hyperglycemia inhibits basal and stimulated plasma PP secretion, suggesting impaired vagal-cholinergic tone during hyperglycemia.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Pitt HA, King W, Mann LL, Roslyn JJ, Berquist WE, Ament ME, DenBesten L: Increased risk of cholelithiasis with prolonged total parenteral nutrition. Am J Surg 145:106–111, 1983

    Google Scholar 

  2. Roslyn JJ, Pitt HA, Man LL, Ament ME, DenBesten L: Gallbladder disease in patients on long-term parenteral nutrition. Gastroenterology 84:148–154, 1983

    Google Scholar 

  3. Linden W van der, Nakayama F: Effect of intravenous fat on hepatic bile. Acta Chir Scand 192:401–406, 1976

    Google Scholar 

  4. Cano N, Cicero F, Ranieri F, Martin J, DiConstanzo J: Ultrasonographic study of gallbladder motility during total parenteral nutrition. Gastroenterology 91:313–317, 1986

    Google Scholar 

  5. Nealon WH, Upp JR, Alexander RW, Gomez G, Townsend CM, Thompson JC: Intravenous amino acids stimulate human gallbladder emptying and hormone release. Am J Physiol 259:G173-G178, 1990

    Google Scholar 

  6. De Boer SY, Lam WF, Jebbink MCW, Masclee AAM, Jansen JBMJ, Lamers CBHW: Hyperglycemia reduces gallbladder emptying and plasma hormone secretion to modified sham feeding and regular feeding. Hepatology 17:1022–1027, 1993

    Google Scholar 

  7. De Boer SY, Masclee AAM, Jebbink MCW, Schipper J, Lemkes HHPJ, Jansen JBJM, Lamers CBHW: Effect of hyperglycemia on gallbladder contraction induced by cholecystokinin in humans. Gut 34:1128–1132, 1993

    Google Scholar 

  8. De Boer SY, Masclee AAM, Jebbink MCW, Schipper J, Jansen JBMJ, Lamers CBHW: The effect of intravenous fat on cholecystokinin secretion and gallbladder motility in man. JPEN 16:16–19, 1992

    Google Scholar 

  9. Schwartz TW: Pancreatic polypeptide: A hormone under vagal control. Gastroenterology 85:1411–1425, 1983

    Google Scholar 

  10. Everson GT, Braverman DJ, Johnson ML, Kern F: A critical evaluation of real-time ultrasonography for the study of gallbladder volume and contraction. Gastroenterology 79:40–46, 1980

    Google Scholar 

  11. Hopman WPM, Brouwer WFM, Rosenbusch G, Jansen JBMJ, Lamers CBHW: A computerized method for rapid quantification of gallbladder volume from real-time ultrasounds. Radiology 154:36–37, 1985

    Google Scholar 

  12. De Fronzo RA, Tobin JD, Andres R: Glucose clamp technique: A method for quantifying insulin secretion and resistance. Am J Physiol 237:E214-E223, 1979

    Google Scholar 

  13. Ward WK, Halter JB, Beard JB, Bear JC, Potr D: Adaptation of B and A cell function during prolonged glucose infusion in human subjects. Am J Physiol 246:E405-E411, 1984

    Google Scholar 

  14. Jansen JBMJ, Lamers CBHW: Radioimmunoassay of cholecystokinin in human tissue and plasma. Clin Chim Acta 131:305–316, 1983

    Google Scholar 

  15. Jansen JBMJ, Lamers CBHW: Molecular forms of cholecystokinin in plasma from normal and gastrectomized subjects following a fat meal. Peptides 8:801–805, 1987

    Google Scholar 

  16. Lamers CBHW, Diemel JM, van Leer E, van Leusen R, Peetoom J: Mechanisms of elevated serum pancreatic polypeptide concentration in chronic renal failure. J Clin Endocrinol Metab 55:922–926, 1982

    Google Scholar 

  17. Konturek SJ, Kwiecien N, Obtulowicz W, Mikos E, Sito E, Oleksy J: Comparison of intraduodenal and intravenous administration of amino acids on gastric secretion in healthy subjects and patients with duodenal ulcer. Gut 19:859–864, 1978

    Google Scholar 

  18. DiMagno EP, Go VLW, Summerskill WHJ: Intraluminal and postabsorptive affects of amino acids on pancreatic enzyme secretion. J Lab Clin Med 82:241–248, 1973

    Google Scholar 

  19. Hopman WPM, Jansen JBMJ, Lamers CBHW: Comparative study of the effects of equal amounts of fat, protein and starch on plasma cholecystokinin in man. Scand J Gastroenterol 20:843–847, 1985

    Google Scholar 

  20. Ertan A, Brooks FP, Ostrow JP, Arvan DA, Williams CN, Cerda JJ: Effect of jejunal amino acid perfusion and exogenous cholecystokinin on the exocrine pancreatic and biliary secretion in man. Gastroenterology 61:686–692, 1971

    Google Scholar 

  21. Isenberg JI, Maxwell V: Intravenous infusion of amino acids stimulates gastric acid secretion in man. N Engl J Med 298:27–29, 1978

    Google Scholar 

  22. Niederau C, Sonnenberg A, Erckenbrecht J: Effects of intravenous infusion of amino acids, fat, or glucose on unstimulated pancreatic secretion in healthy humans. Dig Dis Sci 30:445–455, 1985

    Google Scholar 

  23. Wiener I, Inoue K, Fagan CJ, Lilja P, Watson LC, Thompson JC: Release of cholecystokinin in man: Correlation of blood levels with gallbladder contraction. Ann Surg 194:321–327, 1981

    Google Scholar 

  24. Masclee AAM, Hopman WPM, Corstens FHM, Rosenbusch G, Jansen JBMJ, Lamers CBHW: Simultaneous measurement of gallbladder emptying with cholescintigraphy and ultrasonography during infusion of physiologic doses of cholecystokinin: A comparison. Radiology 173:407–410, 1989

    Google Scholar 

  25. Masclee AAM, Jansen JBMJ, Driessen WMM, Geuskens LM, Lamers CBHW: Plasma cholecystokinin and gallbladder responses to intraduodenal fat in gallstone patients. Dig Dis Sci 34:353–359, 1989

    Google Scholar 

  26. Fisher RS, Rock E, Malmud LS: Cholinergic effects on gallbladder emptying in humans. Gastroenterology 89:716–722, 1985

    Google Scholar 

  27. Hopman WPM, Jansen JBMJ, Rosenbusch G, Lamers CBHW: Cephalic stimulation of gallbladder contraction in humans: Role of cholecystokinin and the cholinergic system. Digestion 38:197–203, 1987

    Google Scholar 

  28. McArthur KE, Isenberg JL, Hogan DL, Dreier SJ: Intravenous infusion ofl-isomers of phenylalanine and tryptophan stimulate gastric acid secretion at physiologic plasma concentrations in normal subjects and after parietal cell vagotomy. J Clin Invest 71:1254–1262, 1983

    Google Scholar 

  29. Øster-Jörgensen E, Pedersen SA, Larsen ML: The influence of induced hyperglycemia on gastric emptying in healthy humans. Scand J Clin Lab Invest 50:831–836, 1990

    Google Scholar 

  30. Fraser RJ, Horowitz M, Maddox AF, Harding PE, Chatterton BE, Dent J: Hyperglycemia slows gastric emptying in type 1 (insulin-dependent) diabetes mellitus. Diabetologia 33:675–680, 1990

    Google Scholar 

  31. De Boer SY, Masclee AAM, Lam WF, Lamers CBHW: Effect of acute hyperglycemia on esophageal motility and lower esophageal sphincter pressure in humans. Gastroenterology 103:775–780, 1992

    Google Scholar 

  32. Hirano T, Niijima A: Effects of 2-deoxy-d-glucose, glucose and insulin on efferent activity in gastric vagus nerve. Experientia 36:1197–1198, 1980

    Google Scholar 

  33. Marco J, Hedo JA, Castillo-Olivares J, Villanueva ML: Human pancreatic polypeptide secretion in conditions of exogenous and endogenous hyperglycemia. Diabetologia 19:418–422, 1980

    Google Scholar 

  34. Tsuda K, Seino Y, Mori K, et al: Effect of truncal vagotomy on pancreatic polypeptide responses after intravenous glucose administration. Regul Pept 1:347–352, 1981

    Google Scholar 

  35. Sitzmann JV, Pitt HA, Steinhorn PA, Pasha ZR, Sanders RC: Cholecystokinin prevents parenteral nutrition induced biliary sludge in humans. Surg Gynecol Obstet 170:25–31, 1990

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. University Hospital Nijmegen, The Netherlands

    S. Y. de Boer MD,  A. A. M. Masclee MD, W. F. Lam MD, J. B. M. J. Jansen MD & C. B. H. W. Lamers MD

  2. Department of Gastroenterology and Hepatology, University Hospital, Building 1, C4-P, P.O. Box 9600, 2300 RC, Leiden, The Netherlands

    S. Y. de Boer MD,  A. A. M. Masclee MD, W. F. Lam MD, J. B. M. J. Jansen MD & C. B. H. W. Lamers MD

Authors
  1. S. Y. de Boer MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. A. A. M. Masclee MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. W. F. Lam MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. J. B. M. J. Jansen MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. C. B. H. W. Lamers MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

de Boer, S.Y., Masclee, A.A.M., Lam, W.F. et al. Effect of intravenous glucose on intravenous amino acid-induced gallbladder contraction and CCK secretion. Digest Dis Sci 39, 268–274 (1994). https://doi.org/10.1007/BF02090196

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF02090196

Key words

Search

Navigation