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. 1999 Oct;45(4):559–563. doi: 10.1136/gut.45.4.559

Impaired meal stimulated glucagon-like peptide 2 response in ileal resected short bowel patients with intestinal failure

P Jeppesen 1, B Hartmann 1, B Hansen 1, J Thulesen 1, J Holst 1, P Mortensen 1
PMCID: PMC1727702  PMID: 10486365

Abstract

BACKGROUND—Glucagon-like peptide 2 (GLP-2) is a growth factor for the intestinal epithelium in rodents and may affect intestinal transit.
AIMS—To study the GLP-2 response to nutrient ingestion in seven short bowel patients with intestinal failure and seven controls.
METHODS—The patients and controls were admitted twice for two test meals after a night of fasting. Meal A was liquid (300 ml, 1.88 MJ); meal B was a regular breakfast (755 g, 3.92 MJ). Plasma samples were collected for 180 minutes; GLP-2 immunoreactivity was measured with an NH2 terminal specific radioimmunoassay.
RESULTS—Both meals elicited significant increases in plasma GLP-2 in controls. The magnitude and duration of the responses were dependent on the meal size: the maximum median (25-75%) increases after meal A and B were 24 (3-28) and 48 (33-56) pmol/l. Plasma GLP-2 returned to basal concentrations 180 minutes after meal A, but remained at 50% of peak values after meal B. In the patients neither meal significantly changed the GLP-2 concentration; the maximum median elevation after meal B was 5 (2-8) pmol/l. There were significant differences between patients and controls with respect to the GLP-2 responses to meals A and B.
CONCLUSION—Identification of GLP-2 as a tissue specific intestinal growth factor and demonstration of an impaired meal stimulated GLP-2 response in short bowel patients raises the possibility that GLP-2 administration may constitute a new therapeutic strategy, enhancing jejunal adaptation in ileum resected short bowel patients with intestinal failure.


Keywords: short bowel syndrome; growth factors; intestinal adaptation; human

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Figure 1  .

Figure 1  

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Plasma glucagon-like peptide (GLP) 2 increment after meals A (300 ml Nutridrink) and (solid breakfast) in short bowel patients with a jejunostomy and sex and age matched controls. *p<0.05, **p<0.01, Mann-Whitney rank sum test.

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