The effect of exclusive parenteral nutrition, constant rate enteral nutrition, partial meal feeding, normal oral feeding and etiology on the plasma pancreatic polypeptide levels in children

Abstract

Plasma pancreatic polypeptide (PP) levels were determined by radioimmunoassay in 100 children. Of the 81 children on Total Parenteral Nutrition (TPN), 32 were studied after cyclic TPN (cTPN), 66 after Partial Meal Feeding plus Parenteral Nutrition, 25 after Constant Rate Enteral Nutrition and 18 during Normal Oral Feeding. Nineteen controls received normal alimentation. PP levels during TPN (172 ± 17 pg/ml), cTPN (150 ± 23) and Constant Rate Enteral Nutrition (200 ± 27) were similar to each other and to pre-prandium (p), Normal Oral Feeding (198 ± 22) and controls (196 ± 40). PP increased (p < 0.05) in post-prandium (pp), Partial Meal Feeding (233 ± 23) compared to TPN, cTPN, p Normal Oral Feeding and p controls, but remained at half that of pp Normal Oral Feeding (387 ± 58) and pp controls (410 ± 91, p < 0.001). The p PP levels were significantly reduced in chronic intestinal pseudo-obstruction (CIPO) (90 ± 22, p < 0.02) and short bowel (length < 100 cm) (76 ± 17, p < 0.001), as compared to controls. This study indicates that TPN or Constant Rate Enteral Nutrition do not modify basal PP levels. Normal Oral Feeding and Partial Meal Feeding produce a significant pp stimulation of PP release. Intestinal pathology can interfere with p plasma PP levels.