Gastric emptying of glucose solution and associated plasma concentrations of GLP-1, GIP, and PYY before and after fundoplication

• Published in: Surgical endoscopy Vol. 21; no. 2; pp. 309 - 314
• Main Authors: Miholic, J., Hoffmann, M., Holst, J.J., Lenglinger, J., Mittlböck, M., Bergmann, H., Stacher, G.
• Format: Journal Article
• Language: English
• Published: New York, NY Springer 01.02.2007; Springer Nature B.V
• Subjects: Adult; Aged; Biological and medical sciences; Body Mass Index; Esophagus; Fundoplication - adverse effects; Fundoplication - methods; Gastric Emptying - physiology; Gastric Inhibitory Polypeptide - blood; Gastroenterology. Liver. Pancreas. Abdomen; Gastroesophageal Reflux - diagnosis; Gastroesophageal Reflux - surgery; Gastrointestinal Hormones - blood; Gastrointestinal Hormones - metabolism; General aspects; Glucagon-Like Peptide 1 - blood; Glucose - metabolism; Humans; Male; Medical sciences; Middle Aged; Other diseases. Semiology; Peptide YY - blood; Postoperative Care; Preoperative Care; Probability; Prospective Studies; Severity of Illness Index; Statistics, Nonparametric; Gastroesophageal reflux; Stomach; GIP-GLP-1 -PYY; Pancreatic hormone; Glucagon; Hyperglycemic substances; Peptide hormone; Esophageal disease; Metabolic diseases; Gastric emptying; Concentration; Glucose; Hypoglycemia; Blood plasma; Medicine; Fundoplication; Digestive diseases
• ISSN: 0930-2794; 1432-2218; 1432-2218
• DOI: 10.1007/s00464-005-0804-3

This study was designed to assess the relationship between gastric emptying of glucose solution and the ensuing plasma concentrations of glucagon-like peptide-1 (GLP-1), peptide YY (PYY), and glucose-dependent insulinotropic polypeptide (GIP) in patients having undergone fundoplication for gastroesophageal reflux (GERD). In 10 male patients the emptying of 50% glucose solution was determined scintigraphically and its relationship with plasma glucose, GLP-1, PYY, and GIP concentrations was studied before and 3 months after fundoplication. In the first 30 min after glucose ingestion, emptying was significantly (p = 0.048) faster after fundoplication than before. Emptying and GLP-1 and GIP correlated: the faster the emptying during the first 30 min the greater the concentrations integrated over that period (p = 0.04; p = 0.01; p = 0.02). Emptying and PYY concentrations were unrelated. In the 120-180 min. period, blood glucose concentrations were lower the faster the emptying in the initial 30 min (p = 0.06) and the entire 50-min recording period (p = 0.03) had been. The GLP-1 concentrations integrated over the first 30 min correlated inversely with the integrated plasma glucose during the third hour after ingestion (p = 0.004). After fundoplication, gastric emptying may, if accelerated in its initial phases, give rise to greater and earlier increases in plasma glucose, GLP-1, and GIP concentrations and thus to reactive hypoglycemia.