Human Pancreatic Polypeptide Levels Research Articles

Effect of Electrical Stimulation on Acupuncture Points in Diabetic Patients with Gastric Dysrhythmia: A Pilot Study

Background/Aims: Abnormal gastric slow-wave frequencies have been observed in diabetic gastroparesis and are associated with impaired antral motor activity. In this study, we aimed at evaluating the effect of acupuncture on gastric slow waves in diabetic patients with symptoms suggesting gastric motor dysfunction. Methods: Fifteen patients with type II diabetes who had had dyspeptic symptoms for more than 3 months were enrolled. Two acupuncture needles were inserted into the subjects’ legs at the Zusanli points, and electrical stimulation (2-Hz pulses) was delivered for 30 min. Cutaneous electrogastrography was performed for 30 min at baseline, for 30 min during acupuncture, and for an additional 30 min after acupuncture. Serum gastrin, motilin, and human pancreatic polypeptide levels were also measured. Results: There was a significant increase in the percentages of normal frequency during and after acupuncture (baseline vs. acupuncture and after acupuncture 21.99 ± 19.38% vs. 45.93 ± 19.72 and 48.92 ± 19.56%; p < 0.01). In addition, the percentage of tachygastric frequency was decreased significantly during and after acupuncture. The dominant frequency was also changed significantly. There was an increase of serum human pancreatic polypeptide during acupuncture (baseline vs. acupuncture 56.96 ± 27.64 vs. 73.11 ± 22.37 pmol/l; p < 0.05). Conclusions: The results of this study revealed that electrical stimulation at the Zusanli points could increase the percentage of normal electrogastrography frequency and decrease the percentage of tachygastric frequency in diabetic patients. The data indicate that acupuncture may enhance the regularity of gastric myoelectrical activity in diabetic patients.

Polygraphic analysis of eating on electrogastrography (EGG), heart rate variability, and serum human-pancreatic polypeptide levels: [formula omitted], T. Mitsuma, M. Sakakibara. Fourth Dept. of Internal Medicine, Aichi Medical University, Aichi, 480-11 Japan, and Division of Clinical Psychology, Tokai Central Hospital, Kakamigahara, 504, Japan

Polygraphic analysis of eating on electrogastrography (EGG), heart rate variability, and serum human-pancreatic polypeptide levels: [formula omitted], T. Mitsuma, M. Sakakibara. Fourth Dept. of Internal Medicine, Aichi Medical University, Aichi, 480-11 Japan, and Division of Clinical Psychology, Tokai Central Hospital, Kakamigahara, 504, Japan

Sustained pectin ingestion: effect on gastric emptying and glucose tolerance in non-insulin-dependent diabetic patients.

The effects of sustained pectin ingestion on gastric emptying, glucose tolerance, and hormone responses were studied in 12 stable, non-insulin-dependent (type 2) diabetic patients. Patients were placed on a 2400 kcal, low-fiber (3 g) diet for 2 wk, followed by 4 wk of an isocaloric diet supplemented with 20 g apple pectin/d. Gastric-emptying half-time, plasma glucose, glucagon, and human pancreatic polypeptide levels were determined. Gastric-emptying half-time was prolonged 43% (p less than 0.025) by pectin supplementation and returned to normal 3 d after its discontinuation. Fiber supplementation decreased the incremental area under the glucose tolerance curve from 34.8 +/- 3.0 to 27.9 +/- 3.2 mmol/L (p less than 0.01) but did not affect hormonal responses to a meal. Sustained pectin ingestion slowed the gastric-emptying rate and improved glucose tolerance; however, a direct relationship could not be demonstrated between changes in gastric emptying and changes in the incremental area under the glucose curve (r = 0.22).

Can Plasma Human Pancreatic Polypeptide Be Used To Detect Diseases of the Exocrine Pancreas?

Plasma concentrations of human pancreatic polypeptide (HPP) parallel exocrine pancreatic secretion in response to stimulation with cholecystokinin. We determined prospectively the relationships among fasting HPP level, integrated HPP response to infusion of cholecystokinin, and output of trypsin and also the sensitivity, specificity, and predictive values of the fasting HPP level in the diagnosis of exocrine pancreatic disease. Our study group consisted of 19 patients with acute pancreatitis, 17 with chronic pancreatitis, and 25 with ductal adenocarcinoma of the pancreas and 27 control subjects. In the control patients and those with chronic pancreatitis, significant correlations were detected between HPP level and output of trypsin (P less than 0.001) in response to infusion of cholecystokinin and between fasting HPP and integrated HPP levels (P less than 0.004); no correlation was detected between HPP level and steatorrhea. The sensitivity, specificity, and negative and positive predictive values of the fasting HPP level for detection of either chronic pancreatitis or pancreatic cancer were similar and approximated 0.88, 0.67, 0.88, and 0.66, respectively. The HPP concentration had no value in detecting acute pancreatitis. Because the fasting HPP level has a high degree of negative predictability and is simpler to measure than the integrated HPP level or the output of trypsin, it may be a useful test in patients suspected of having either chronic pancreatitis or pancreatic cancer. A fasting HPP level of 125 pg/ml or greater could be used to exclude chronic pancreatitis or pancreatic cancer, but the finding of a value of less than 125 pg/ml necessitates use of other diagnostic tests for reliable determination of the presence of these diseases.

Effect of cholinergic and adrenergic blockade on human pancreatic polypeptide secretion in healthy subjects.

The effect of cholinergic, alpha-adrenergic, and beta-adrenergic blockade on human pancreatic polypeptide (HPP) release has been tested in six normal subjects before and after a meal. The response to food was abolished by atropine and significantly enhanced by phentolamine and propranolol. The increase induced by phentolamine occurred during the primary phase 0-60 min after food, and that caused by propranolol was observed during the secondary phase 60-120 min postprandially. A radioimmunoassay for HPP, evaluated by accepted criteria of reliability, is described. Various fractions of the 125I-BPP tracer peak have been evaluated. Those of the central portion proved to be superior to the others because of the constant immunoreactivity and the constant incubation damage during the observation period. Serum and plasma samples were subject to different conditions of preservation before analysis of HPP. It is concluded that preservation with aprotinin heparin, collection in chilled tubes, or instant centrifugation and freezing does not improve the stability of HPP after sampling. The present study confirms a positive correlation between age and fasting HPP concentrations (R = 0.15, p = 0.05), but no difference in HPP levels between men and women has been demonstrated.

Release of human pancreatic polypeptide and gastrin in response to intraduodenal stimuli: A case report

A recent clinical case afforded an opportunity to study the effects of duodenal stimulation on plasma human pancreatic polypeptide and gastrin concentrations, independent of gastric stimulation. A distension stimulus was provided by rapid injection of 100 ml of water and saline via a T-tube into an isolated duodenal afferent limb. In a third experiment, the saline contained 200 pg/ml of heptadeca-peptide human gastrin. Within 2 min after each injection, a rapid rise in circulating human pancreatic polypeptide levels appeared that fell promptly towards basal thereafter. Injections of 100 ml of Flexical, a supplemental tube feeding, resulted in a biphasic human pancreatic polypeptide response, the initial peak comparable to that seen following distension with water, saline, or saline containing gastrin, and a second peak of much greater magnitude and duration followed the initial peak. Plasma gastrin concentrations were not influenced following any of the stimuli. Duodenal distension alone may induce an early transient increase in plasma human pancreatic polypeptide concentrations, while intraduodenal nutrients per se may induce a later increment of greater magnitude and duration.