| Gastric Emptying, Incretin Hormone Secretion, and Postprandial Glycemia in Cystic Fibrosis--Effects of Pancreatic Enzyme Supplementation. | |
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MedLine Citation:
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PMID: 21389144 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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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/m(2)) 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. |
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Authors:
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Paul Kuo; Julie E Stevens; Antonietta Russo; Anne Maddox; Judith M Wishart; Karen L Jones; Hugh Greville; David Hetzel; Ian Chapman; Michael Horowitz; Christopher K Rayner |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2011-3-9 |
Journal Detail:
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Title: The Journal of clinical endocrinology and metabolism Volume: - ISSN: 1945-7197 ISO Abbreviation: - Publication Date: 2011 Mar |
Date Detail:
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Created Date: 2011-3-10 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0375362 Medline TA: J Clin Endocrinol Metab Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
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Discipline of Medicine (P.K., J.E.S., A.R., A.M., J.M.W., K.L.J., I.C., M.H., C.K.R.), Royal Adelaide Hospital, University of Adelaide, Adelaide 5000, Australia; Departments of Thoracic Medicine (H.G.) and Gastroenterology and Hepatology (D.H., C.K.R.), Royal Adelaide Hospital, Adelaide 5000, Australia; and The Centre of Research Excellence (P.K., J.E.S., A.R., A.M., J.M.W., K.L.J., I.C., M.H., C.K.R.), University of Adelaide, Adelaide 5000, Australia. |
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