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Impaired meal stimulated glucagon-like peptide 2 response in ileal resected short bowel patients with intestinal failure
  1. P B Jeppesena,
  2. B Hartmannb,
  3. B S Hansena,
  4. J Thulesenb,
  5. J J Holstb,
  6. P B Mortensena
  1. aDepartment of Medicine, Section of Gastroenterology, Rigshospitalet, Copenhagen, Denmark, bDepartment of Medical Physiology, The Panum Institute, University of Copenhagen, Copenhagen, Denmark
  1. Dr P B Jeppesen, Department of Medicine CA-2121, Section of Gastroenterology, Rigshospitalet, Blegdamsvej 9, DK-2100 Copenhagen, Denmark.

Abstract

BACKGROUND Glucagon-like peptide 2 (GLP-2) is a growth factor for the intestinal epithelium in rodents and may affect intestinal transit.

AIMS To study the GLP-2 response to nutrient ingestion in seven short bowel patients with intestinal failure and seven controls.

METHODS The patients and controls were admitted twice for two test meals after a night of fasting. Meal A was liquid (300 ml, 1.88 MJ); meal B was a regular breakfast (755 g, 3.92 MJ). Plasma samples were collected for 180 minutes; GLP-2 immunoreactivity was measured with an NH2 terminal specific radioimmunoassay.

RESULTS Both meals elicited significant increases in plasma GLP-2 in controls. The magnitude and duration of the responses were dependent on the meal size: the maximum median (25–75%) increases after meal A and B were 24 (3–28) and 48 (33–56) pmol/l. Plasma GLP-2 returned to basal concentrations 180 minutes after meal A, but remained at 50% of peak values after meal B. In the patients neither meal significantly changed the GLP-2 concentration; the maximum median elevation after meal B was 5 (2–8) pmol/l. There were significant differences between patients and controls with respect to the GLP-2 responses to meals A and B.

CONCLUSION Identification of GLP-2 as a tissue specific intestinal growth factor and demonstration of an impaired meal stimulated GLP-2 response in short bowel patients raises the possibility that GLP-2 administration may constitute a new therapeutic strategy, enhancing jejunal adaptation in ileum resected short bowel patients with intestinal failure.

  • short bowel syndrome
  • growth factors
  • intestinal adaptation
  • human
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Footnotes

  • Abbreviations used in this paper:
    BEE
    basal energy expenditure
    GLP-2
    glucagon-like peptide 2
    PGDP
    proglucagon derived peptides

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