TY - JOUR
T1 - Alterations in Enteroendocrine Hormones after Total Pancreatectomy with Islet Autotransplantation
AU - McEachron, Kendall R.
AU - Yang, Yi
AU - Hodges, James S.
AU - Beilman, Gregory J.
AU - Pruett, Timothy L.
AU - Kirchner, Varvara A.
AU - Dunn, Ty B.
AU - Freeman, Martin L.
AU - Trikudanathan, Guru
AU - Mulier, Kristine E.
AU - Ptacek, Peggy
AU - Bellin, Melena D.
PY - 2020/7
Y1 - 2020/7
N2 - 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. © 2020 Wolters Kluwer Health, Inc. All rights reserved.
AB - 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. © 2020 Wolters Kluwer Health, Inc. All rights reserved.
KW - autoislet
KW - GLP-1
KW - pancreatectomy
KW - pancreatic polypeptide
KW - PYY
KW - Roux-en-Y
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U2 - 10.1097/MPA.0000000000001582
DO - 10.1097/MPA.0000000000001582
M3 - RGC 21 - Publication in refereed journal
C2 - 32541637
SN - 0885-3177
VL - 49
SP - 806
EP - 811
JO - Pancreas
JF - Pancreas
IS - 6
ER -