Proximal and distal gut hormone secretion in irritable bowel syndrome.
OBJECTIVE
Sensory and motor dysfunctions of the gut are both important characteristics of irritable bowel syndrome (IBS). Several gut peptides contribute to the regulation of gastrointestinal function but little is known about gut hormone secretion in IBS.


METHODS
We evaluated perceptual thresholds and fasting and postprandial plasma levels of proximal (cholecystokinin (CCK), motilin) and distal (peptide YY) gut peptides up to 1 h after ingestion of a high caloric meal in 99 IBS patients and 40 age- and gender-matched healthy controls.


RESULTS
Fasting plasma CCK levels were significantly elevated in patients (1.2+/-0.8 pM) compared with those in controls (0.8+/-0.7 pM, p=0.006), as was the incremental postprandial CCK response (72+/-73 versus 40+/-42 pM.60 min, respectively; p=0.003). No differences in fasting and postprandial motilin or PYY levels were found. The postprandial PYY response was significantly increased in hypersensitive compared to normosensitive patients (215+/-135 versus 162+/-169 pM, p=0.048). Patients with a diarrhoea predominant bowel habit had higher fasting motilin levels compared to constipated patients or alternating type IBS patients (82.1+/-36.5 versus 60.8+/-25.1 versus 57.5+/-23.9 pM, one-way ANOVA p=0.003).


CONCLUSIONS
IBS patients have increased fasting and postprandial plasma levels of CCK. Changes in plasma levels of motilin and PYY may contribute to the clinical expression of IBS, such as the presence of visceral hypersensitivity or a predominant bowel habit.
Department of Gastroenterology and Hepatology, Leiden University Medical Centre, Leiden, The Netherlands.
Patrick P J
PP
Van Der Veek
Izäk
I
Biemond
Ad A M
AA
Masclee
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D015415:Biomarkers / Q000097:blood; D002766:Cholecystokinin / Q000378:metabolism*; D005215:Fasting / Q000097:blood; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007421:Intestine, Small / Q000378:metabolism; D043183:Irritable Bowel Syndrome / Q000097:blood* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009037:Motilin / Q000378:metabolism*; D019894:Peptide YY / Q000378:metabolism*; D019518:Postprandial Period; D011613:Psychotherapy / Q000379:methods; D011863:Radioimmunoassay; D012189:Retrospective Studies; D012737:Sex Factors
D015415:Biomarkers; D019894:Peptide YY; D009037:Motilin; D002766:Cholecystokinin