title: Hyperglycemia reduces pancreaticobiliary secretion in response to modified sham feeding in humans.
abstract: OBJECTIVE
  We have investigated the effect of acute hyperglycemia on pancreaticobiliary secretion and pancreatic polypeptide (PP) release.
  
  
  METHODS
  Duodenal outputs of bilirubin, trypsin, lipase, amylase and bicarbonate were measured using a recovery marker under basal conditions and in response to modified sham feeding (MSF) in 6 healthy subjects on two separate occasions: during normoglycemia and during acute hyperglycemia (15 mmol/l).
  
  
  RESULTS
  During hyperglycemia the basal pancreaticobiliary output was significantly (p < 0.05) reduced. During normoglycemia MSF significantly (p < 0.05) increased the output of bilirubin and pancreatic enzymes; during hyperglycemia only the output of pancreatic enzymes increased significantly (p < 0.05) over basal. During MSF the outputs of bilirubin (16 +/- 4 vs. 4 +/- 2 micromol/30 min), trypsin (26 +/- 7 vs. 7 +/- 4 U/30 min), lipase (36 +/- 11 vs. 15 +/- 6 kU/30 min), amylase (3.4 +/- 0.7 vs. 1.4 +/- 0.7 kU/30 min) and bicarbonate (0.8 +/- 0.1 vs. 0.5 +/- 0.1 mmol/30 min) were significantly (p < 0.05) reduced during hyperglycemia compared to normoglycemia. During hyperglycemia basal and MSF-stimulated PP levels were significantly (p < 0.05) reduced compared to normoglycemia. MSF did not significantly influence plasma cholecystokinin levels in both experiments.
  
  
  CONCLUSIONS
  This study indicates (1) that the blood glucose levels affect basal and cephalic stimulated pancreaticobiliary secretion and (2) that the PP secretion during hyperglycemia is reduced, suggesting impaired vagal cholinergic activity during hyperglycemia.
authors: Department of Gastroenterology-Hepatology, Leiden University Medical Center, Leiden, The Netherlands.
authors: W F
authors: WF
authors: Lam
authors: M E
authors: ME
authors: Lindeboom
authors: C B
authors: CB
authors: Lamers
authors: A A
authors: AA
authors: Masclee
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D001659:Biliary Tract / Q000378:metabolism*; D001786:Blood Glucose / Q000032:analysis; D002766:Cholecystokinin / Q000097:blood; D005215:Fasting; D005260:Female; D006801:Humans; D006943:Hyperglycemia / Q000097:blood / Q000503:physiopathology*; D008297:Male; D010179:Pancreas / Q000378:metabolism*; D010191:Pancreatic Polypeptide / Q000097:blood; D011863:Radioimmunoassay
chemical_list: D001786:Blood Glucose; D010191:Pancreatic Polypeptide; D002766:Cholecystokinin