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Type: Journal article
Title: Endogenous amylin and glucagon-like peptide-1 concentrations are not associated with gastric emptying in critical illness
Author: Summers, M.
Di Bartolomeo, A.
Zaknic, A.
Chapman, M.
Nguyen, Q.
Zacharakis, B.
Rayner, C.
Horowitz, M.
Deane, A.
Citation: Acta Anaesthesiologica Scandinavica: an international journal of anaesthesiology and intensive care, pain and emergency medicine, 2014; 58(2):235-242
Publisher: John Wiley & Sons
Issue Date: 2014
ISSN: 0001-5172
Statement of
M. J. Summers, A. E. Di Bartolomeo, A. V. Zaknic, M. J. Chapman, N. Q. Nguyen, B. Zacharakis, C. K. Rayner, M. Horowitz and A. M. Deane
Abstract: BACKGROUND: In health, the hormones amylin and glucagon-like peptide-1 (GLP-1) slow gastric emptying (GE) and modulate glycaemia. The aims of this study were to determine amylin and GLP-1 concentrations in the critically ill and their relationship with GE, glucose absorption and glycaemia. METHODS: In fasted critically ill and healthy subjects (n = 26 and 23 respectively), liquid nutrient, containing 100 mg (13) C-sodium octanoate and 3 g 3-O-methlyglucose (3-OMG), was administered via a nasogastric tube. Amylin, GLP-1, glucose and 3-OMG concentrations were measured in blood samples taken during fasting, and 30 min and 60 min after the 'meal'. Breath samples were taken to determine gastric emptying coefficient (GEC). Intolerance to intragastric feeding was defined as a gastric residual volume of ≥ 250 ml and/or vomiting within the 24 h prior to the study. RESULTS: Although GE was slower (GEC: critically ill 2.8 ± 0.9 vs. health, 3.4 ± 0.2; P = 0.002), fasting blood glucose was higher (7.0 ± 1.9 vs. 5.7 ± 0.2 mmol/l; P = 0.005) and overall glucose absorption was reduced in critically ill patients (3-OMG: 9.4 ± 8.0 vs. 17.7 ± 4.9 mmol/l.60 min; P < 0.001), there were no differences in fasting or postprandial amylin concentrations. Furthermore, although fasting [1.7 (0.4-7.2) vs. 0.7 (0.3-32.0) pmol/l; P = 0.04] and postprandial [3.0 (0.4-8.5) vs. 0.8 (0.4-34.3) pmol/l; P = 0.02] GLP-1 concentrations were increased in the critically ill and were greater in feed intolerant when compared with those tolerating feed [3.7 (0.4-7.2) vs. 1.2 (0.7-4.6) pmol/l; P = 0.02], there were no relationships between GE and fasting amylin or GLP-1 concentrations. CONCLUSION: In the critically ill, fasting GLP-1, but not amylin, concentrations are elevated and associated with feed intolerance. Neither amylin nor GLP-1 appears to substantially influence the rate of GE.
Keywords: Humans
Critical Illness
Blood Glucose
Breath Tests
Cohort Studies
Gastric Emptying
Aged, 80 and over
Middle Aged
Glucagon-Like Peptide 1
Young Adult
Islet Amyloid Polypeptide
Description: This is the pre-peer reviewed version of the following article: Summers, Matthew J.; Di Bartolomeo, Anna; Zaknic, Antony V.; Chapman, Marianne J.; Nguyen, Nam; Zacharakis, Betty; Rayner, Chris Keith; Horowitz, Michael; Deane, Adam Matthew, Endogenous amylin and glucagon-like peptide-1 concentrations are not associated with gastric emptying in critical illness, Acta Anaesthesiologica Scandinavica, 2014; 58(2):235-242, which has been published in final form at
Rights: © 2014 The Acta Anaesthesiologica Scandinavica Foundation
DOI: 10.1111/aas.12252
Appears in Collections:Anaesthesia and Intensive Care publications
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