Abstract
The aim of the present study was to investigate the effect of acute hyperglycemia on (1) the intestinal phase of gallbladder contraction induced by the intraduodenal administration of emulsified fat, and (2) the small intestinal transit time measured by the lactulose breath hydrogen test. Six healthy volunteers were studied in random order during normoglycemia and hyperglycemia (blood glucose levels 15 mmol/liter). Gallbladder volumes were measured with ultrasonography. Administration of 1 and 2 g/hr of fat resulted in significant reductions in gallbladder volumes from 24±2 cm3 to 11±1 cm3 (P<0.05) and 8±1 cm3 (P<0.05), respectively during normoglycemia, and from 24±2 cm3 to 21±2 cm3 (P<0.05) and 16±2 cm3, respectively (P<0.05) during hyperglycemia. Compared to normoglycemia, the gallbladder contraction was significantly (P<0.05) reduced during hyperglycemia. No significant differences in CCK secretion were observed between experiments. Small intestinal transit time during hyperglycemia (101±12 min) was significantly (P<0.05) prolonged compared to normoglycemia (57±12 min). During hyperglycemia, basal PP levels and PP secretion in response to intraduodenal fat were significantly (P<0.05) reduced compared to normoglycemia. It is concluded that (1) low doses of intraduodenal emulsified fat result in significant gallbladder contraction and CCK secretion, (2) acute hyperglycemia inhibits intraduodenal fat induced gallbladder contraction, (3) acute hyperglycemia does not affect the intraduodenal fat induced CCK secretion, (4) small intestinal transit is significantly prolonged during acute hyperglycemia, and (5) acute hyperglycemia inhibits basal and stimulated plasma PP secretion, suggesting impaired vagal-cholinergic tone during hyperglycemia.
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References
McGregor IL, Gueller R, Watts HD, Meyer JH: The effect of acute hyperglycemia on gastric emptying in man. Gastroenterology 70:190–196, 1976
Barnett JL, Owyang C: Serum glucose concentration as a modulator of interdigestive gastric motility. Gastroenterology 94:739–744, 1988
Fraser R, Horowitz M, Dent J: Hyperglycemia stimulates pyloric motility in normal subjects. Gut 32:475–478, 1990
Oster-Jorgensen 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
Groop L, Luzi L, DeFronzo RA, Melander A. Hyperglycemia and absorption of sulfonylurea drugs. Lancet 2:129–130, 1989
Feldman M, Schiller LR: Disorders of gastrointestinal motility associated with diabetes mellitus. Ann Intern Med 98:378–384, 1983
Stone BG, Gavaler JS, Belle SH, Shreiner DP, Peleman RR, Sarva RP, Yingvorapant N, Van Thiel DH: Impairment of gallbladder emptying in diabetes mellitus. Gastroenterology 95:170–176, 1988
Ewing DJ, Clarke BF: Autonomic neuropathy: Its diagnosis and prognosis. Clin Endocrinol Metab 15:855–888, 1986
Horowitz M, Harding PE, Maddox AF, Wishart JM, Akkermans JMA, Chatterton BE, Shearman DJC: Gastric and oesophageal emptying in patients with type 2 (non-insulin-dependent) diabetes mellitus. Diabetologia 32:151–159, 1989
Fraser RJ, Horowitz M, Maddox AF, Harding PE, Chatterton BE, Dent J. Hyperglycemia shows gastric emptying in type I (insulin-dependent) diabetes mellitus. Diabetologia 33:675–680, 1990
De Boer SY, Masclee AAM, Jebbink MCW, Schipper J, Lemkes HHPJ, Jansen JBMJ, Lamers CBHW. Effect of hyperglycemia on gallbladder motility. Hepatology 12:873, 1990 (abstract)
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
Hopman WPM, Brouwer WFM, Rosenbusch G, Jansen JBMJ, Lamers CBHW: A computerized method for rapid quantification of gallbladder volume from real-time sonograms. Radiology 154:230–237, 1985
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
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
Bond JR, Levitt MD: Investigation of small bowel transit time in man using pulmonary hydrogen measurements. J Lab Clin Med 85:546–555, 1975
Jansen JBMJ, Lamers CBHW: Radioimmunoassay of cholecystokinin in human tissue and plasma. Clin Chim Acta 131:305–316, 1983
Jansen JBMJ, Lamers CBHW: Molecular forms of cholecystokinin in plasma from normal and gastrectomized human subjects following a fat meal. Peptides 8:801–805, 1987
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
Fiorucci S, Bosso R, Morelli A: Duodenal osmolality drives gallbladder emptying in humans. Dig Dis Sci 35:698–704, 1990
Hopman WPM, Jansen JBMJ, Rosenbusch G, Lamers CBHW: Role of cholecystokinin and the cholinergic system in intestinal stimulation of gallbladder contraction in man. Hepatology 11:261–265, 1990
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
Scarpello JHB, Greaves M, Sladen GE: Small intestinal transit time in diabetics. Br Med J 2:1225–1226, 1976
Keshvarzian A, Iber FL: Intestinal transit in insulinrequiring diabetics. Am J Gastroenterol 81:257–260, 1986
Dooley CP, El Nehiwi HM, Zeidler A, Valenzuela JE: Abnormalities of the migrating motor complex in diabetics with autonomic neuropathy and diarrhea. Scand J Gastroenterol 23:217–223, 1988
Spengler U, Stellaard F, Ruckdeschel G, Scheurlen C, Kruis W: Small intestinal transit time, bacterial growth and bowel habits in diabetic patients. Pancreas 4:65–70, 1989
Read NW, McFarlane A, Kinsman RI, Bates TE, Blackhall NW, Farrar GBJ, Hall JC, Moss G, Morris AP, O'Neill B, Welch I, Lee Y, Bloom SR: Effect of infusion of nutrient solutions into the iluem on gastrointestinal transit and plasma levels of neurotensin and enteroglucagon. Gastroenterology 86:274–280, 1984
Prasad KR, Sarna SK: The central and periferal effects of insulin on migrating myoelectric complexes. Gastroenterology 90:1589, 1986 (abstract)
Bueno L, Ruckebusch M: Insulin and jejunal electrical activity in dog and sheep. Am J Gastroenterol 82:840–843, 1987
Lee KY, Zhuo L, Ren XS, Chang TM, Chey WY: An important role of endogenous insulin on exocrine pancreatic secretion in rats. Am J Physiol 258:G268-G274, 1990
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
De Boer SY, Lam WF, Jebbink MCW, Masclee AAM, Jansen JBMJ, Lamers CBHW: Effect of hyperglycemia on gallbladder motility and plasma hormone secretion. Gut 32:A1210, 1991 (abstract)
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
Schwartz TW: Pancreatic polypeptide: a hormone under vagal control. Gastroenterology 85:1411–1425, 1983
Schwartz TW, Stenquist B, Olbe L: Cephalic phase of pancreatic polypeptide secretion studied by sham feeding in man. Scand J Gastroenterol 14:313–320, 1979
Meier R, Hildebrand P, Thumshirn M, Albrecht C, Studer B, Gyr C, Geglinger C: Effect of loxiglumide, a cholecystokinin antagonist on pancreatic polypeptide release in humans. Gastroenterology 99:1757–1762, 1990
Tsuda K, Seino Y, Mori K, Seino S, Takemura J, Kuzuya H, Yamamura T, Kotoura Y, Ito N, Imura H: Effect of truncal vagotomy on pancreatic polypeptide responses after intravenous glucose administration. Regul Pept 1:347–352, 1981
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De Boer, S.Y., Masclee, A.A.M., Lam, W.F. et al. Hyperglycemia modulates gallbladder motility and small intestinal transit time in man. Digest Dis Sci 38, 2228–2235 (1993). https://doi.org/10.1007/BF01299901
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DOI: https://doi.org/10.1007/BF01299901