Plasma glucagon-like peptide 1 and peptide YY levels are not altered in symptomatic fructose-sorbitol malabsorption.
OBJECTIVE
Carbohydrate malabsorption causes more symptoms in patients with functional gastrointestinal disorders than in healthy individuals. The purpose of this study was to investigate whether this could be explained by differences in ileal brake hormone secretion.


METHODS
Eighteen consecutive patients with functional abdominal complaints, referred to our clinic for investigation of self-reported food hypersensitivity, were included in the study and compared with 15 healthy volunteers. All subjects ingested a mixture of 25 g fructose and 5 g sorbitol. Pulmonary hydrogen and methane excretion and plasma glucagon-like peptide 1 (GLP-1) and peptide YY (PYY) levels were measured during the next 3 h. Both habitual and post-test symptoms were assessed.


RESULTS
Malabsorption of fructose and sorbitol was present in 61% of the patients and 73% of the controls. Nevertheless, the patients experienced significantly more symptoms following carbohydrate challenge, and 78% of the patients claimed that the challenge replicated their habitual gastrointestinal complaints. No significant differences in gas excretion or GLP-1 and PYY levels were found between patients and controls or between symptomatic and asymptomatic carbohydrate malabsorbers. A weak correlation between hydrogen excretion and PYY levels was demonstrated in non-producers of methane.


CONCLUSIONS
Neither intestinal gas production nor ileal brake hormone secretion seems to play a role in the symptomatology of carbohydrate intolerance in patients with self-reported food hypersensitivity. Other mechanisms related to bacterial fermentation may be involved and should be investigated further.
Valeur
Jørgen
J
Institute of Medicine, Section for Gastroenterology, University of Bergen, Norway. jorgen.valeur@med.uib.no
Øines
Eliann
E
Morken
Mette Helvik
MH
Holst
Jens Juul
JJ
Berstad
Arnold
A
D000328:Adult; D001944:Breath Tests; D016022:Case-Control Studies; D005260:Female; D005512:Food Hypersensitivity / Q000097:blood* / Q000209:etiology; D005632:Fructose / Q000009:adverse effects; D052216:Glucagon-Like Peptide 1 / Q000097:blood*; D006801:Humans; D008286:Malabsorption Syndromes / Q000097:blood* / Q000209:etiology; D008297:Male; D008875:Middle Aged; D019894:Peptide YY / Q000097:blood*; D013012:Sorbitol / Q000009:adverse effects
D019894:Peptide YY; D005632:Fructose; D013012:Sorbitol; D052216:Glucagon-Like Peptide 1