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Abnormal Ghrelin and Pancreatic Polypeptide Responses in Gastroparesis

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Abstract

Vagal nerve dysfunction has been implicated in the pathogenesis of diabetic gastroparesis, but its role in idiopathic gastroparesis remains uncertain. The incre-ase in pancreatic polypeptide with sham feeding is often used as a measure of vagal integrity. Ghrelin has been suggested to function as an appetite-stimulating hormone from the gut to the brain acting through vagal afferent pathways. Systemic ghrelin also rises in part due to vagal efferent pathways. Alterations in ghrelin and its effects on appetite could play a role in gastroparesis. In this study we aimed [1] to investigate the presence of vagal nerve dysfunction in patients with idiopathic and diabetic gastroparesis and [2] to determine if alterations in ghrelin concentrations occur in gastroparesis. Normal subjects and patients with diabetic, idiopathic, or postsurgical gastroparesis underwent a sham feeding protocol. Serial blood samples were obtained for plasma ghrelin and pancreatic polypeptide. Sham feeding was characterized by an increase in pancreatic polypeptide and ghrelin in normal controls and patients with idiopathic gastroparesis. The changes in pancreatic polypeptide and ghrelin levels in diabetic and postsurgical gastroparesis were significantly less than those in normal subjects. Vagal nerve dysfunction, as evidenced by an impaired pancreatic polypeptide response with sham feeding, is present in diabetic gastroparesis but not idiopathic gastroparesis. Systemic ghrelin concentrations increased with sham feeding in normal subjects and patients with idiopathic gastroparesis but not in diabetic or postsurgical gastroparesis. Vagal function and regulation of ghrelin levels are impaired in diabetic gastroparesis.

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Acknowledgements

This study was supported in part by NIH K24 DK02921 Midcareer Investigator Award in Patient-Oriented Research (H. P. Parkman), by NIH Grants R01-DK58895, R01-DK066003, and R01-HL0733267 (Guenther Boden), and by the NIH GCRC Program of the NCRR (RR00349).

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Authors and Affiliations

  1. Section of Gastroenterology, Department of Medicine, Temple University School of Medicine, Philadelphia, Pennsylvania, USA

    Kishore V. Gaddipati, Hrair P. Simonian & Henry P. Parkman

  2. Section of Endocrinology, Department of Medicine, Temple University School of Medicine, Philadelphia, Pennsylvania, USA

    Karen M. Kresge & Guenther H. Boden

  3. Section of General Clinical Research Center, Temple University School of Medicine, Philadelphia, Pennsylvania, USA

    Karen M. Kresge, Guenther H. Boden & Henry P. Parkman

  4. Gastroenterology Section, Parkinson Pavilion, 8th Floor, Temple University Hospital, 3401 North Broad Street, Philadelphia, Pennsylvania, 19140, USA

    Henry P. Parkman

Authors
  1. Kishore V. Gaddipati
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  2. Hrair P. Simonian
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  3. Karen M. Kresge
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  4. Guenther H. Boden
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  5. Henry P. Parkman
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Corresponding author

Correspondence to Henry P. Parkman.

Additional information

The results of this study were presented at the 2004 Digestive Disease Week in New Orleans, Louisiana, with the abstract appearing in Gastroenterology, Volume 126, A587, 2004.

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Gaddipati, K.V., Simonian, H.P., Kresge, K.M. et al. Abnormal Ghrelin and Pancreatic Polypeptide Responses in Gastroparesis. Dig Dis Sci 51, 1339–1346 (2006). https://doi.org/10.1007/s10620-005-9022-z

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  • DOI: https://doi.org/10.1007/s10620-005-9022-z

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