Gastroparesis is associated with oxytocin deficiency, oesophageal dysmotility with hyperCCKemia, and autonomic neuropathy with hypergastrinemia.
BACKGROUND
Gastrointestinal (GI) dysmotility and autonomic neuropathy are common problems among diabetics with largely unknown aetiology. Many peptides are involved in the autonomic nervous system regulating the GI tract. The aim of this study was to examine if concentrations of oxytocin, cholecystokinin (CCK), gastrin and vasopressin in plasma differ between diabetics with normal function and dysfunction in GI motility.


METHODS
Nineteen patients with symptoms from the GI tract who had been examined with gastric emptying scintigraphy, oesophageal manometry, and deep-breathing test were included. They further received a fat-rich meal, after which blood samples were collected and plasma frozen until analysed for hormonal concentrations.


RESULTS
There was an increase in postprandial oxytocin plasma concentration in the group with normal gastric emptying (p = 0.015) whereas subjects with delayed gastric emptying had no increased oxytocin secretion (p = 0.114). Both CCK and gastrin levels increased after the meal, with no differences between subjects with normal respective delayed gastric emptying. The concentration of vasopressin did not increase after the meal. In patients with oesophageal dysmotility the basal level of CCK tended to be higher (p = 0.051) and those with autonomic neuropathy had a higher area under the curve (AUC) of gastrin compared to normal subjects (p = 0.007).


CONCLUSIONS
Reduced postprandial secretion of oxytocin was found in patients with delayed gastric emptying, CCK secretion was increased in patients with oesophageal dysmotility, and gastrin secretion was increased in patients with autonomic neuropathy. The findings suggest that disturbed peptide secretion may be part of the pathophysiology of digestive complications in diabetics.
Borg
Julia
J
Department of Clinical Sciences, Gastroenterology Division, Malmö University Hospital, Lund University, Lund, Sweden. julia.faraj@med.lu.se
Melander
Olle
O
Johansson
Linda
L
Uvnäs-Moberg
Kerstin
K
Rehfeld
Jens F
JF
Ohlsson
Bodil
B
D001342:Autonomic Nervous System Diseases / Q000097:blood / Q000150:complications / Q000503:physiopathology; D016022:Case-Control Studies; D002766:Cholecystokinin / Q000097:blood*; D003929:Diabetic Neuropathies / Q000097:blood* / Q000150:complications / Q000503:physiopathology; D015154:Esophageal Motility Disorders / Q000097:blood* / Q000150:complications / Q000503:physiopathology; D005260:Female; D005746:Gastric Emptying / Q000502:physiology; D005755:Gastrins / Q000097:blood*; D018589:Gastroparesis / Q000097:blood* / Q000150:complications / Q000503:physiopathology; D006801:Humans; D008297:Male; D010121:Oxytocin / Q000097:blood*; D014667:Vasopressins / Q000097:blood
D005755:Gastrins; D014667:Vasopressins; D010121:Oxytocin; D002766:Cholecystokinin