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https://hdl.handle.net/2440/65658
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Type: | Journal article |
Title: | Gastric emptying, incretin hormone secretion, and postprandial glycemia in cystic fibrosis - Effects of pancreatic enzyme supplementation |
Author: | Kuo, P. Stevens, J. Russo, A. Maddox, A. Wishart, J. Jones, K. Greville, H. Hetzel, D. Chapman, I. Horowitz, M. Rayner, C. |
Citation: | Journal of Clinical Endocrinology and Metabolism, 2011; 96(5):E851-E855 |
Publisher: | Endocrine Society |
Issue Date: | 2011 |
ISSN: | 0021-972X 0021-972X |
Statement of Responsibility: | Paul Kuo, Julie E. Stevens, Antonietta Russo, Anne Maddox, Judith M. Wishart, Karen L. Jones, Hugh Greville, David Hetzel, Ian Chapman, Michael Horowitz, and Christopher K. Rayner |
Abstract: | Context: Postprandial hyperglycemia is an important clinical problem in cystic fibrosis (CF), but the contribution of fat malabsorption, rapid gastric emptying, and the incretin axis has not been widely considered. Objective: The aim of this study was to evaluate these aspects of gut function in nondiabetic CF patients. Design and Setting: We conducted a randomized, double-blind, placebo-controlled crossover study at a clinical research laboratory. Patients: Five nondiabetic CF patients (three males; age, 25.8 ± 1.0 yr; body mass index, 20.2 ± 1.1 kg/m2) with exocrine pancreatic insufficiency and six healthy subjects of similar age and body mass index participated in the study. Interventions: CF patients consumed a radiolabeled mashed potato meal on 2 separate days, together with four capsules of Creon Forte (100,000 IU lipase) or placebo. Healthy subjects consumed the meal once, without pancreatic enzymes. Main Outcome Measures: Gastric emptying was measured using scintigraphy, and blood was sampled frequently for blood glucose and plasma glucagon-like peptide-1 (GLP-1), glucose-dependent insulinotropic polypeptide (GIP), and glucagon concentrations. Results: CF patients had more rapid gastric emptying (P < 0.001), impaired secretion of GLP-1 (P < 0.01) and GIP (P < 0.001), and greater postprandial glycemic excursions (P < 0.001) than healthy subjects. Pancreatic enzyme supplementation normalized gastric emptying and GLP-1 secretion and tended to increase glucagon (P = 0.08), but did not completely restore GIP secretion or normalize postprandial blood glucose. There was an excellent correlation between gastric emptying and blood glucose concentration at 60 min (R = 0.75; P = 0.01). Conclusions: Pancreatic enzyme supplementation plays an important role in incretin secretion, gastric emptying, and postprandial hyperglycemia in CF. |
Keywords: | Pancreas Humans Cystic Fibrosis Hyperglycemia Gastric Inhibitory Polypeptide Glucagon Insulin Lipase Dietary Carbohydrates Blood Glucose Dietary Fats Double-Blind Method Gastric Emptying Adult Female Male Glucagon-Like Peptide 1 Incretins Young Adult |
Rights: | Copyright © 2011 by The Endocrine Society |
DOI: | 10.1210/jc.2010-2460 |
Published version: | http://dx.doi.org/10.1210/jc.2010-2460 |
Appears in Collections: | Aurora harvest Medicine publications |
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