Effects of cholecystokinin receptor blockade on circulating concentrations of glucose, insulin, C-peptide, and pancreatic polypeptide after various meals in healthy human volunteers.
This study used a cholecystokinin (CCK) antagonist to evaluate whether CCK that is released after regular meals regulates meal-stimulated insulin secretion. Several experiments were performed in eight to 10 healthy male volunteers, each in duplicate. The subjects received different meals either with or with i.v. infusion of 5 mg/kg/h of the CCK antagonist loxiglumide (Rotta, Italy). The mixed solid-liquid meals of 600, 800, or 1,000 kcal consisting of regular German food were given orally. In addition, studies were carried out in which a liquid test meal of 750 kcal was infused into the duodenum over a 2-hour period to exclude effects of the CCK antagonist on gastric emptying. Finally, the subjects received an oral load of 100 g glucose either with or without i.v. infusion of loxiglumide. Loxiglumide at the dose used completely abolishes the actions of endogenous CCK and of exogenous CCK when given at doses that mimic postprandial circulating concentrations of this peptide at various target organs such as gallbladder, pancreas, stomach, and intestine. Loxiglumide also markedly reduced the increase in pancreatic polypeptide seen after the intraduodenal infusion of nutrients. However, loxiglumide at this dose did not alter the increase in circulating concentrations of glucose, insulin, and C-peptide after any of the various oral meals, after the intraduodenal administration of nutrients, and after the oral load of glucose. Although the present study does not rule out that in some conditions CCK may increase insulin secretion in humans, the results do rule out that CCK acts as a major physiologic incretin in healthy humans.
Niederau
C
C
Medizinische Klinik und Poliklinik, Abteilung für Gastroenterologie, Heinrich-Heine-Universität Düsseldorf, Germany.
Schwarzendrube
J
J
Lüthen
R
R
Niederau
M
M
Strohmeyer
G
G
Rovati
L
L
D000284:Administration, Oral; D000328:Adult; D001786:Blood Glucose / Q000032:analysis*; D002096:C-Peptide / Q000097:blood*; D002766:Cholecystokinin / Q000037:antagonists & inhibitors* / Q000097:blood / Q000502:physiology; D004032:Diet; D004305:Dose-Response Relationship, Drug; D005947:Glucose / Q000008:administration & dosage / Q000494:pharmacology; D006801:Humans; D007262:Infusions, Intravenous; D007328:Insulin / Q000097:blood*; D008297:Male; D010191:Pancreatic Polypeptide / Q000097:blood*; D011377:Proglumide / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000494:pharmacology; D011949:Receptors, Cholecystokinin / Q000187:drug effects*
D001786:Blood Glucose; D002096:C-Peptide; D007328:Insulin; D011949:Receptors, Cholecystokinin; D010191:Pancreatic Polypeptide; C053737:loxiglumide; D002766:Cholecystokinin; D011377:Proglumide; D005947:Glucose