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Eur J Endocrinol. 2014 Oct;171(4):407-19. doi: 10.1530/EJE-14-0309. Epub 2014 Jul 1.

Postprandial gallbladder emptying in patients with type 2 diabetes: potential implications for bile-induced secretion of glucagon-like peptide 1.

Author information

1
Diabetes Research DivisionDepartment of Medicine, Gentofte Hospital, University of Copenhagen, Niels Andersens Vej 65, DK-2900 Hellerup, DenmarkThe NNF Center for Basic Metabolic ResearchDepartment of Biomedical Sciences, The Panum Institute, University of Copenhagen, Copenhagen, DenmarkDepartment of Clinical BiochemistryCopenhagen University Hospital Rigshospitalet, Copenhagen, Denmark Diabetes Research DivisionDepartment of Medicine, Gentofte Hospital, University of Copenhagen, Niels Andersens Vej 65, DK-2900 Hellerup, DenmarkThe NNF Center for Basic Metabolic ResearchDepartment of Biomedical Sciences, The Panum Institute, University of Copenhagen, Copenhagen, DenmarkDepartment of Clinical BiochemistryCopenhagen University Hospital Rigshospitalet, Copenhagen, Denmark dpsonne@gmail.com.
2
Diabetes Research DivisionDepartment of Medicine, Gentofte Hospital, University of Copenhagen, Niels Andersens Vej 65, DK-2900 Hellerup, DenmarkThe NNF Center for Basic Metabolic ResearchDepartment of Biomedical Sciences, The Panum Institute, University of Copenhagen, Copenhagen, DenmarkDepartment of Clinical BiochemistryCopenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.
3
Diabetes Research DivisionDepartment of Medicine, Gentofte Hospital, University of Copenhagen, Niels Andersens Vej 65, DK-2900 Hellerup, DenmarkThe NNF Center for Basic Metabolic ResearchDepartment of Biomedical Sciences, The Panum Institute, University of Copenhagen, Copenhagen, DenmarkDepartment of Clinical BiochemistryCopenhagen University Hospital Rigshospitalet, Copenhagen, Denmark Diabetes Research DivisionDepartment of Medicine, Gentofte Hospital, University of Copenhagen, Niels Andersens Vej 65, DK-2900 Hellerup, DenmarkThe NNF Center for Basic Metabolic ResearchDepartment of Biomedical Sciences, The Panum Institute, University of Copenhagen, Copenhagen, DenmarkDepartment of Clinical BiochemistryCopenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.

Abstract

OBJECTIVE:

Recent preclinical work has suggested that postprandial flow of bile acids into the small intestine potentiates nutrient-induced glucagon-like peptide 1 (GLP1(GCG)) secretion via bile acid-induced activation of the G protein-coupled receptor TGR5 in intestinal L cells. The notion of bile-induced GLP1 secretion combined with the findings of reduced postprandial gallbladder emptying in patients with type 2 diabetes (T2DM) led us to speculate whether reduced postprandial GLP1 responses in some patients with T2DM arise as a consequence of diabetic gallbladder dysmotility.

DESIGN AND METHODS:

In a randomised design, 15 patients with long-standing T2DM and 15 healthy age-, gender- and BMI-matched control subjects were studied during 75-g oral glucose tolerance test (OGTT) and three isocaloric (500 kcal) and isovolaemic (350 ml) liquid meals: i) 2.5 g fat, 107 g carbohydrate and 13 g protein; ii) 10 g fat, 93 g carbohydrate and 11 g protein; and iii) 40 g fat, 32 g carbohydrate and 3 g protein. Basal and postprandial plasma concentrations of glucose, insulin, C-peptide, glucagon, GLP1, glucose-dependent insulinotropic polypeptide (GIP), cholecystokinin and gastrin were measured. Furthermore, gallbladder emptying and gastric emptying were examined.

RESULTS:

Gallbladder emptying increased with increasing meal fat content, but no intergroup differences were demonstrated. GIP and GLP1 responses were comparable among the groups with GIP levels being higher following high-fat meals, whereas GLP1 secretion was similar after both OGTT and meals.

CONCLUSIONS:

In conclusion, patients with T2DM exhibited normal gallbladder emptying to meals with a wide range of fat content. Incretin responses were similar to that in controls, and an association with postprandial gallbladder contraction could not be demonstrated.

PMID:
24986531
DOI:
10.1530/EJE-14-0309
[Indexed for MEDLINE]

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