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Alterations in Enteroendocrine Hormones After Total Pancreatectomy With Islet Autotransplantation.

自体胰岛移植全胰腺切除术后肠内分泌激素的改变。

  • 影响因子:2.16
  • DOI:10.1097/MPA.0000000000001582
  • 作者列表:"McEachron KR","Yang Y","Hodges JS","Beilman GJ","Pruett TL","Kirchner VA","Dunn TB","Freeman ML","Trikudanathan G","Mulier KE","Ptacek P","Bellin MD
  • 发表时间:2020-06-12
Abstract

OBJECTIVE:When total pancreatectomy with islet autotransplantation (TPIAT) is performed for chronic pancreatitis, the pancreas and most of the duodenum are removed, with Roux-en-Y reconstruction of the gastrointestinal tract. Enteroendocrine cells in the intestines and pancreas secrete hormones coordinating digestion and motility, but anatomic reconstruction alters transit of nutrients to these cells. We hypothesized that TPIAT leads to changes in enteroendocrine hormones. METHODS:Glucagon-like peptide 1 (GLP-1), peptide YY (PYY), and pancreatic polypeptide (PP) were measured from mixed-meal tolerance tests of 34 clinical trial participants before and 18 months after TPIAT. Area under the curve of GLP-1 and PYY-stimulated responses were calculated by trapezoidal method, and the PP response was measured as the stimulated max minus baseline (ΔPP). RESULTS:Area under the curve of GLP-1 and PYY increased significantly after TPIAT (GLP-1 average +553.1 pg/mL per minute, P = 0.004; PYY average +4647.9 pg/mL per minute, P = 0.02). ΔPP trended toward lower after TPIAT (average, -52.2 pg/mL, P = 0.06). CONCLUSIONS:In this novel study of enteroendocrine hormones in TPIAT patients, stimulated levels of GLP-1 and PYY were significantly higher after versus before TPIAT. ΔPP was lower after TPIAT, but not significantly. These hormone changes have potential clinical implications that warrant further research.

摘要

目的: 慢性胰腺炎行全胰腺切除加自体胰岛移植 (TPIAT) 时,切除胰腺和大部分十二指肠,行胃肠道 Roux-en-Y 重建。肠和胰腺中的肠内分泌细胞分泌协调消化和运动的激素,但解剖重建改变了营养物质向这些细胞的转运。我们假设 TPIAT 导致肠内分泌激素的变化。 方法: 胰高血糖素样肽 1 (GLP-1) 、肽 YY (PYY) 和胰多肽 (PP) 在 TPIAT 前和 18 个月后对 34 名临床试验参与者进行混合餐耐受性试验。通过梯形法计算 GLP-1 和 PYY 刺激反应的曲线下面积,并测量 PP 反应作为刺激的最大值减去基线 (Δ PP)。 结果: TPIAT 后 GLP-1 和 PYY 的曲线下面积显著增加 (GLP-1 平均每分钟 + 553.1 pg/mL,P = 0.004; PYY 平均每分钟 + 4647.9 pg/mL,P = 0.02)。TPIAT 后 Δ pp 趋向于更低 (平均值,-52.2 pg/mL,P = 0.06)。 结论: 在这项关于 TPIAT 患者肠内分泌激素的新研究中,与 TPIAT 前相比,TPIAT 后刺激的 GLP-1 和 PYY 水平显著升高。TPIAT 后 Δ pp 较低,但不显著。这些激素变化具有潜在的临床意义,值得进一步研究。

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影响因子:2.30
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