Faculty Collaboration Database

Alterations in Enteroendocrine Hormones After Total Pancreatectomy With Islet Autotransplantation. Pancreas 2020 Jul;49(6):806-811

Date

06/17/2020

Pubmed ID

32541637

Pubmed Central ID

PMC7321866

DOI

10.1097/MPA.0000000000001582

Scopus ID

2-s2.0-85087133790 (requires institutional sign-in at Scopus site)   5 Citations

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.

Author List

McEachron KR, Yang Y, Hodges JS, Beilman GJ, Pruett TL, Kirchner VA, Dunn TB, Freeman ML, Trikudanathan G, Mulier KE, Ptacek P, Bellin MD

Author

Ty Blink Dunn MD Professor in the Surgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adult
Enteroendocrine Cells
Female
Gastrointestinal Hormones
Glucagon-Like Peptide 1
Humans
Islets of Langerhans Transplantation
Male
Middle Aged
Pancreatectomy
Pancreatic Hormones
Pancreatic Polypeptide
Pancreatitis, Chronic
Peptide YY
Transplantation, Autologous