Document Detail


Gastric Emptying, Incretin Hormone Secretion, and Postprandial Glycemia in Cystic Fibrosis--Effects of Pancreatic Enzyme Supplementation.
MedLine Citation:
PMID:  21389144     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
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.
Authors:
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
Related Documents :
15235774 - Risk factor management in diabetic and non-diabetic patients with coronary heart diseas...
16873794 - Effects of traditional and western environments on prevalence of type 2 diabetes in pim...
17243524 - Microalbuminuria prevalence study in hypertensive type 2 diabetic patients in malaysia.
20015964 - Prevalence and characteristics of diabetes among homeless people attending shelters in ...
7646324 - Evaluating lyophilized human serum preparations for suitability as proficiency testing ...
6409624 - Relationship between muscle morphology and metabolism in obese women: the effects of lo...
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-3-9
Journal Detail:
Title:  The Journal of clinical endocrinology and metabolism     Volume:  -     ISSN:  1945-7197     ISO Abbreviation:  -     Publication Date:  2011 Mar 
Date Detail:
Created Date:  2011-3-10     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0375362     Medline TA:  J Clin Endocrinol Metab     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
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.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Long-Term Follow-Up of Patients with Papillary and Follicular Thyroid Cancer: A Prospective Study on...
Next Document:  TWIST1 Plays a Pleiotropic Role in Determining the Anaplastic Thyroid Cancer Phenotype.