Effects of growth hormone deficiency and recombinant growth hormone therapy on postprandial gallbladder motility and cholecystokinin release.
In addition to cholecystokinin, other hormones have been suggested to be involved in regulation of postprandial gallbladder contraction. We aimed to evaluate effects of growth hormone (GH) on gallbladder contractility and cholecystokinin release. Gallbladder and gastric emptying (by ultrasound) and cholecystokinin release were determined before and after 6 months of recombinant human GH (rhGH) therapy in 12 patients with GH deficiency, after either a mixed (n = 5) or a liquid (n = 7) meal. Basal postprandial gallbladder contraction was severely impaired (19 +/- 2 and 26 +/- 3% of fasting volume after mixed and liquid meal, respectively). Histology and cholecystokinin sulfation patterns in duodenal biopsies from two patients were normal. After 6 months of rhGH therapy, fasting gallbladder volumes increased (from 20.8 +/- 0.9 to 25.9 +/- 1.1 mL, P < 0.05) and postprandial gallbladder emptying was restored (70 +/- 6 and 70 +/- 7% of fasting volume after mixed and liquid meal, respectively), without change of gastric emptying. Cholecystokinin secretion after a mixed meal and gallbladder sensitivity to cholecystokinin were significantly enhanced during rhGH replacement compared to the basal state. Postprandial cholecystokinin release, gallbladder responsiveness to cholecystokinin, and gallbladder emptying are severely impaired in the absence of GH. Reversibility during GH suppletion suggests its involvement in regulation of gallbladder contractility.
Moschetta
Antonio
A
Department of Gastroenterology, University Medical Center Utrecht, Utrecht, The Netherlands.
Twickler
Th B
TB
Rehfeld
Jens F
JF
van Ooteghem
Nancy A M
NA
Cabezas
Manuel Castro
MC
Portincasa
Piero
P
van Berge-Henegouwen
Gerard P
GP
van Erpecum
Karel J
KJ
D000293:Adolescent; D000328:Adult; D002766:Cholecystokinin / Q000097:blood / Q000378:metabolism*; D005260:Female; D005704:Gallbladder / Q000502:physiology / Q000503:physiopathology*; D016473:Gallbladder Emptying / Q000502:physiology*; D005769:Gastrointestinal Motility; D013006:Growth Hormone / Q000172:deficiency*; D019382:Human Growth Hormone / Q000627:therapeutic use*; D006801:Humans; D007262:Infusions, Intravenous; D007334:Insulin-Like Growth Factor I / Q000032:analysis; D008297:Male; D008875:Middle Aged; D019518:Postprandial Period
D019382:Human Growth Hormone; D007334:Insulin-Like Growth Factor I; D013006:Growth Hormone; D002766:Cholecystokinin