Serum fasting GLP-1 and GLP-2 associate with intestinal adaptation in pediatric onset intestinal failure.
Glukagon-like-peptide-1 (GLP-1) and -2 (GLP-2), produced by intestinal L-cells, are key hormones regulating intestinal transit, secretion, absorption, and mucosal growth. We evaluated naïve fasting serum GLP-1 and GLP-2 levels in pediatric intestinal failure (IF).



Fifty-five IF patients with median age 4.2 (IQR 1.3-12) years and 47 matched healthy controls underwent measurement of fasting serum GLP-1 and GLP-2.



Serum GLP-2 [19.9 (13.8-27.9) vs 11.6 (7.0-18.6) ng/mL, P < 0.001], but not GLP-1 [6.1 (4.0-15.7) vs 6.4 (3.9-10.7) ng/mL, P = 0.976], levels were increased in IF patients. Serum GLP-2 concentrations were higher in patients with small bowel-colic continuity [21.1 (15.0-30.7) ng/mL] compared to patients with an endostomy [10.4 (6.6-17.9) ng/mL, P = 0.028], whereas no association with preservation of ileum or ileocecal valve was observed. During PN delivery, GLP-2 inversely associated with remaining small bowel length (r = -0.500, P = 0.041) and frequency of PN infusions (r = -0.549, P = 0.042). Serum GLP-1 levels were lower in patients receiving PN currently [4.1 (2.8-5.1)] compared to patients, who had weaned off PN [6.5 (5.1-21.1), P = 0.005], and correlated positively with duration of PN (r = 0.763, P = 0.002) and negatively with percentage parenteral energy requirement (r = -0.716, P = 0.006).



In pediatric IF, serum GLP-2 levels increase in patients with small bowel-colic continuity proportionally to the length of resected small intestine. Increase in serum GLP-1 and GLP-2 levels paralleled reducing requirement for parenteral support. These findings support regulation of intestinal adaption by GLP-2 and GLP-1 in children with IF.
Section of Pediatric Surgery, Pediatric Liver and Gut Research Group, Children's Hospital, Helsinki University Central Hospital, University of Helsinki, Helsinki, Finland. Electronic address: annika.mutanen@helsinki.fi.
Annika
A
Mutanen
Section of Pediatric Surgery, Pediatric Liver and Gut Research Group, Children's Hospital, Helsinki University Central Hospital, University of Helsinki, Helsinki, Finland.
Mikko P
MP
Pakarinen
D000222:Adaptation, Physiological; D000293:Adolescent; D015992:Body Mass Index; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D002956:Citrulline / Q000097:blood; D003430:Cross-Sectional Studies; D005215:Fasting; D005260:Female; D052216:Glucagon-Like Peptide 1 / Q000097:blood*; D053767:Glucagon-Like Peptide 2 / Q000097:blood*; D006801:Humans; D007223:Infant; D007410:Intestinal Diseases / Q000097:blood* / Q000175:diagnosis* / Q000628:therapy; D007422:Intestines / Q000503:physiopathology; D008297:Male; D010288:Parenteral Nutrition
D053767:Glucagon-Like Peptide 2; D002956:Citrulline; D052216:Glucagon-Like Peptide 1
Children; Parenteral nutrition; Short bowel syndrome