A role for pancreatic polypeptide in the regulation of gastric emptying and short-term metabolic control.
BACKGROUND
Previous studies using pancreatic polypeptide (PP) infusions in humans have failed to show an effect on gastric emptying, glucose metabolism, and insulin secretion. This might be due to the use of nonhuman sequences of the peptide.


OBJECTIVE
The objective of this study was to use synthetic human PP to study gastric emptying rates of a solid meal and postprandial hormone secretion and glucose disposal as well as the gastric emptying rate of water.


METHODS
This was a single-blind study.


METHODS
The study was performed at a university hospital.


METHODS
Fourteen healthy adult subjects were studied.


METHODS
Infusion of saline or PP at 0.75 or 2.25 pmol/kg.min was given to eight subjects (gastric emptying of solid food), and infusion of saline or PP at 2.25 pmol/kg.min was given to six subjects (gastric emptying of water).


METHODS
The main outcome measures were gastric emptying of solids (scintigraphy), hunger ratings (visual analog scale), and plasma concentrations of PP, insulin, glucagon, somatostatin, glucagon-like peptide 1, glucose, and gastric emptying of plain water (scintigraphy).


RESULTS
PP prolonged the lag phase and the half-time of emptying of the solid meal. The change in hunger rating, satiety, desire to eat after the meal, or prospective consumption was not affected. The postprandial rise in plasma glucose was prolonged by PP. The postprandial rise in insulin was also delayed by PP. PP had no significant effect on the emptying of water.


CONCLUSIONS
PP inhibits gastric emptying of solid food and delays the postprandial rise in plasma glucose and insulin. PP is suggested to have a physiological role in the pancreatic postprandial counterregulation of gastric emptying and insulin secretion.
Schmidt
P T
PT
Department of Gastroenterology and Hepatology, Karolinska University Hospital, Solna, SE-171 76 Stockholm, Sweden. peter.thelin.schmidt@medks.ki.se
Näslund
E
E
Grybäck
P
P
Jacobsson
H
H
Holst
J J
JJ
Hilsted
L
L
Hellström
P M
PM
D000328:Adult; D001066:Appetite; D001786:Blood Glucose / Q000378:metabolism*; D018592:Cross-Over Studies; D004435:Eating; D005260:Female; D005502:Food; D005746:Gastric Emptying / Q000187:drug effects*; D005934:Glucagon / Q000097:blood; D006728:Hormones / Q000097:blood / Q000378:metabolism*; D006801:Humans; D007328:Insulin / Q000097:blood; D008297:Male; D010147:Pain Measurement; D010191:Pancreatic Polypeptide / Q000097:blood / Q000138:chemical synthesis / Q000494:pharmacology*; D019518:Postprandial Period / Q000502:physiology*; D012016:Reference Values; D012527:Satiation / Q000187:drug effects; D016037:Single-Blind Method; D014867:Water / Q000378:metabolism
D001786:Blood Glucose; D006728:Hormones; D007328:Insulin; D014867:Water; D010191:Pancreatic Polypeptide; D005934:Glucagon