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Esophageal and gastric dysmotilities are associated with altered glucose homeostasis and plasma levels of incretins and leptin

Hammersjö, Rebecka; Roth, Bodil LU ; Höglund, Peter LU and Ohlsson, Bodil LU (2016) In Review of Diabetic Studies 13(1). p.79-90
Abstract

BACKGROUND: Gastrointestinal complications in diabetes may affect glucose and endocrine homeostasis. Glucosedependent insulinotropic peptide (GIP), glucagon-like peptide-1 (GLP-1), and leptin regulate glucose homeostasis, food intake, and gastric emptying. AIM: The aim was to investigate associations between diabetes complications and glucose homeostasis and plasma levels of GIP, GLP-1, and leptin. METHODS: Sixteen diabetes patients (seven men) were examined with gastric emptying scintigraphy and 72-h continuous subcutaneous glucose monitoring, 14 with the deep-breathing test, and 12 with esophageal manometry. A fiber-rich breakfast was given during the second day of glucose registration. Blood samples were taken 10 min and right before... (More)

BACKGROUND: Gastrointestinal complications in diabetes may affect glucose and endocrine homeostasis. Glucosedependent insulinotropic peptide (GIP), glucagon-like peptide-1 (GLP-1), and leptin regulate glucose homeostasis, food intake, and gastric emptying. AIM: The aim was to investigate associations between diabetes complications and glucose homeostasis and plasma levels of GIP, GLP-1, and leptin. METHODS: Sixteen diabetes patients (seven men) were examined with gastric emptying scintigraphy and 72-h continuous subcutaneous glucose monitoring, 14 with the deep-breathing test, and 12 with esophageal manometry. A fiber-rich breakfast was given during the second day of glucose registration. Blood samples were taken 10 min and right before a fat-rich breakfast, as well as 10, 20, 30, 45, 60, 90, 120, 150, and 180 min afterwards. 20 healthy volunteers acted as controls. Plasma was analyzed regarding GIP, GLP-1, and leptin by Luminex. RESULTS: Gastroparesis lowered maximal concentration (c-max) (p = 0.003) and total area under the curve (tAUC) (p = 0.019) of glucose levels as well as d-min (p = 0.043) of leptin levels. It tended to lower baseline (p = 0.073), c-max (p = 0.066), change from baseline (dmax) (p = 0.073), and tAUC (p = 0.093) of GLP-1 concentrations. Esophageal dysmotility tended to lower tAUC of glucose levels (p = 0.063), and c-min (p = 0.065) and tAUC (p = 0.063) of leptin levels. Diabetes patients had a higher baseline concentration of glucose (p = 0.013), GIP (p = 0.023), and leptin (p = 0.019) compared with healthy subjects. CONCLUSIONS: Gastric and esophageal dysmotility are associated with both lesser increases in postprandial glucose elevations and decreased postprandial changes in GLP-1 and leptin.

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Autonomic neuropathy, Diabetes mellitus, Esophageal dysmotility, Gastroparesis, Incretins, Leptin
in
Review of Diabetic Studies
volume
13
issue
1
pages
79 - 90
external identifiers
  • scopus:85006821270
ISSN
1613-6071
DOI
10.1900/RDS.2016.13.79
language
English
LU publication?
yes
id
76ff914f-8570-4634-adf9-663b48e3523f
date added to LUP
2017-01-19 15:27:49
date last changed
2017-10-20 03:00:16
@article{76ff914f-8570-4634-adf9-663b48e3523f,
  abstract     = {<p>BACKGROUND: Gastrointestinal complications in diabetes may affect glucose and endocrine homeostasis. Glucosedependent insulinotropic peptide (GIP), glucagon-like peptide-1 (GLP-1), and leptin regulate glucose homeostasis, food intake, and gastric emptying. AIM: The aim was to investigate associations between diabetes complications and glucose homeostasis and plasma levels of GIP, GLP-1, and leptin. METHODS: Sixteen diabetes patients (seven men) were examined with gastric emptying scintigraphy and 72-h continuous subcutaneous glucose monitoring, 14 with the deep-breathing test, and 12 with esophageal manometry. A fiber-rich breakfast was given during the second day of glucose registration. Blood samples were taken 10 min and right before a fat-rich breakfast, as well as 10, 20, 30, 45, 60, 90, 120, 150, and 180 min afterwards. 20 healthy volunteers acted as controls. Plasma was analyzed regarding GIP, GLP-1, and leptin by Luminex. RESULTS: Gastroparesis lowered maximal concentration (c-max) (p = 0.003) and total area under the curve (tAUC) (p = 0.019) of glucose levels as well as d-min (p = 0.043) of leptin levels. It tended to lower baseline (p = 0.073), c-max (p = 0.066), change from baseline (dmax) (p = 0.073), and tAUC (p = 0.093) of GLP-1 concentrations. Esophageal dysmotility tended to lower tAUC of glucose levels (p = 0.063), and c-min (p = 0.065) and tAUC (p = 0.063) of leptin levels. Diabetes patients had a higher baseline concentration of glucose (p = 0.013), GIP (p = 0.023), and leptin (p = 0.019) compared with healthy subjects. CONCLUSIONS: Gastric and esophageal dysmotility are associated with both lesser increases in postprandial glucose elevations and decreased postprandial changes in GLP-1 and leptin.</p>},
  author       = {Hammersjö, Rebecka and Roth, Bodil and Höglund, Peter and Ohlsson, Bodil},
  issn         = {1613-6071},
  keyword      = {Autonomic neuropathy,Diabetes mellitus,Esophageal dysmotility,Gastroparesis,Incretins,Leptin},
  language     = {eng},
  month        = {03},
  number       = {1},
  pages        = {79--90},
  series       = {Review of Diabetic Studies},
  title        = {Esophageal and gastric dysmotilities are associated with altered glucose homeostasis and plasma levels of incretins and leptin},
  url          = {http://dx.doi.org/10.1900/RDS.2016.13.79},
  volume       = {13},
  year         = {2016},
}