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Gut 2000;47:370-376 ( September )

Article

Elevated plasma glucagon-like peptide 1 and 2 concentrations in ileum resected short bowel patients with a preserved colon P B Jeppesena, B Hartmannc, J Thulesenb, B S Hansena, J J Holstc, S S Poulsenb, P B Mortensena

a Department of Medicine CA-2121, Section of Gastroenterology, Rigshospitalet, University of Copenhagen, Denmark, b Department of Medical Anatomy, Panum Institute, University of Copenhagen, Denmark, c Department of Physiology, Panum Institute, University of Copenhagen, Denmark

Correspondence to: Dr P B Jeppesen, Department of Medicine CA-2121, Section of Gastroenterology, Rigshospitalet, Blegdamsvej 9, DK-2100 Copenhagen, Denmark. Email: Bekker{at}dadlnet.dk

Accepted for publication 4 April 2000

BACKGROUND---The glucagon-like peptides (GLP) 1 and 2 are secreted postprandially from L cells located mainly in the ileum. Both hormones prolong intestinal transit and GLP-2 is intestinotrophic in rodents. Patients with a jejunostomy have poor adaptation, rapid gastric and intestinal transit, and impaired postprandial GLP-2 secretion. Ileum resected short bowel patients with a preserved colon show evidence of functional adaptation and have normal gastric emptying.
AIM---To investigate if GLP-1 and GLP-2 contribute to the positive effects of a preserved colon in short bowel patients by measuring circulating levels of GLP-1 and GLP-2 in seven ileum resected short bowel patients with a preserved colon and seven age and sex matched controls.
METHODS---GLP-1 and GLP-2 immunoreactivity was measured by specific radioimmunoassays in plasma collected at fasting and at regular intervals 180 minutes after a test meal.
RESULTS---Median (25-75%) fasting GLP-2 values were 72 (69-105) pmol/l versus 23 (19-27) pmol/l (p=0.001) and meal stimulated area under the curve was 21 078 (14 811-26 610) min×pmol/l versus 11 150 (7151-12 801) min×pmol/l (p=0.01) in short bowel patients with a preserved colon compared with control subjects. Fasting GLP-1 values were 10 (6-12) pmol/l versus 5 (3-5) pmol/l (p=0.01) and meal stimulated area under the curve was 3418 (2966-6850) min×pmol/l versus 2478 (1929-3199) min×pmol/l (p=0.04), respectively.
CONCLUSION---Ileum resected short bowel patients with a preserved colon had elevated fasting plasma concentrations of GLP-1 and GLP-2 and significantly larger meal stimulated areas under the curve compared with age and sex matched controls. Elevated GLP-1 and GLP-2 concentrations may contribute to the positive effects of a preserved colon on intestinal motility and functional adaptation in ileum resected short bowel patients.


Keywords: short bowel syndrome; colon; glucagon-like peptides; intestinal adaptation; intestinal transit

© 2000 by Gut


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