The release of gastric inhibitory peptide, glucagon-like peptide-I, and insulin after oral glucose test in colectomized subjects.
BACKGROUND
The physiologic role of the colon as an endocrine organ is not clear. We therefore studied the enteroinsular axis in patients with ulcerative colitis after colectomy.


METHODS
The subjects included 11 patients with a conventional ileostomy, 10 patients with an ileoanal reservoir, and 10 normal controls. The concentrations of glucose, insulin, gastric inhibitory peptide (GIP), and glucagon-like peptide-I (GLP-I) were measured in plasma during an oral glucose test.


RESULTS
The peak level of glucose and peak levels and area under the curve (AUC) of insulin and GIP were higher in patients (P < 0.05). Neither the peak level nor the AUC of GLP-I differed between patients and controls, but time to peak level was four times longer in patients with an ileoanal reservoir (P < 0.05).


CONCLUSIONS
Colectomy seems to affect the enteroinsular axis, leading to hyperinsulinemia and an impaired glucose tolerance. Moreover, patients with an ileoanal reservoir have a slower GLP-I response after intake of glucose.
Palnaes Hansen
C
C
Dept. of Gastrointestinal Surgery, Rigshospitalet, Copenhagen, Denmark.
Andreasen
J J
JJ
Holst
J J
JJ
D000328:Adult; D001786:Blood Glucose / Q000378:metabolism; D003082:Colectomy; D003093:Colitis, Ulcerative / Q000601:surgery; D005260:Female; D005749:Gastric Inhibitory Polypeptide / Q000097:blood / Q000378:metabolism*; D005934:Glucagon / Q000097:blood / Q000378:metabolism*; D052216:Glucagon-Like Peptide 1; D005951:Glucose Tolerance Test; D006801:Humans; D007081:Ileostomy; D007328:Insulin / Q000097:blood / Q000378:metabolism*; D000078790:Insulin Secretion; D007413:Intestinal Mucosa / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D010446:Peptide Fragments / Q000097:blood / Q000378:metabolism*; D016737:Proctocolectomy, Restorative; D011498:Protein Precursors / Q000097:blood / Q000378:metabolism*
D001786:Blood Glucose; D007328:Insulin; D010446:Peptide Fragments; D011498:Protein Precursors; D005749:Gastric Inhibitory Polypeptide; D052216:Glucagon-Like Peptide 1; D005934:Glucagon