Circulating Immunoreactive Somatostatin in Gastrointestinal Diseases: Decrease after Vagotomy and Enhancement in Active Ulcerative Colitis, Irritable Bowel Syndrome, and Duodenal Ulcer
Jaume BinimelisSusan M. WebbJoan MonésJosé SerranoRoser CasamitjanaM. ElenaMiguel A. PeinadoF VilardellAlberto de Leiva
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The main source of circulating immunoreactive somatostatin (IRS) seems to be the gastrointestinal tract. We therefore investigated plasma IRS in patients with various gastrointestinal diseases. Mean basal IRS oscillated between 46 and 73 pg/ml. A postprandial rise was observed in all patients and age-matched controls. However, the increment was significantly higher in patients with duodenal ulcer (159 ± 20 pg/ ml), active ulcerative colitis (176 ± 17 pg/ml), and irritable bowel syndrome (194.4 ± 20.4 pg/ml). Patients with duodenal ulcers who underwent vagotomy showed a decreased postprandial increment (107 ± 10 pg/ml) when compared with active duodenal ulcer patients. No difference was demonstrable between controls and individuals with gastric ulcer, and patients with inactive ulcerative colitis. These results suggest that vagal innervation plays a role in postprandial IRS stimulation, whereas gastric hyperacidity, acute lesions of the colonic mucosa, and hypermotility of the gastrointestinal tract are associated with an exaggerated postprandial IRS response. Since somatostatin is known to influence many gastrointestinal functions, these variations in circulating IRS concentrations may be of pathophysiologic importance.Keywords:
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Fasting and two-hour postprandial serum bile acid concentrations were measured in ten normal subjects and 26 patients with hepatobiliary disease. The two-hour postprandial serum bile acid was the only test with abnormal results in all 26 cases. No significant postprandial elevations occurred in normal controls. Ten patients had abnormal twohour postprandial serum bile acid values in association with normal fasting levels, and all showed a minimum 70% two-hour postprandial increase. A two-hour postprandial serum bile acid determination is a sensitive screening test for hepatobiliary disorders.
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Objective To investigate the relationship between postprandial blood lipid,serum insulin and blood glucose in the patients with type 2 diabetes (DM2).Methods 60 patients with DM2 were studied and their fasting and postprandial levels of blood lipid,apolipoprotein(Apo),serum insulin(Ins),plasma glucose(PG) were measured.Results (1)The levels of fasting and postprandial PG,Ins,TG were significantly increased and HDL and ApoA 1/ApoB 100 remarkably decreased, being compared with normal controls (P0.05);(2)Postprandial TG、LDL were positively correlated with fasting Ins (P0.05),Postprandial TC was positively correlated with postprandial PG (P0.05).Conclusion Patients with DM2 have significant disorder of postprandial blood lipid and lipoprotein metabolism, being remarkably correlated with the levels of postprandial PG and fasting Ins.
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Postprandial hyperlipemia produces long-term derangements in lipid/lipoprotein metabolism, vascular endothelial dysfunction, hypercoagulability, and sympathetic hyperactivity which are strongly linked to atherogenesis. The purpose of this review is to (1) provide a qualitative analysis of the available literature examining the dysregulation of postprandial lipid metabolism in the presence of obesity, (2) inspect the role of adiposity distribution and sex on postprandial lipid metabolism, and (3) examine the role of energy deficit (exercise- and/or energy restriction-mediated), isoenergetic low-carbohydrate diets, and omega-3 (n-3) fatty acid supplementation on postprandial lipid metabolism. We conclude from the literature that central adiposity primarily accounts for sex-related differences in postprandial lipemia and that aerobic exercise attenuates this response in obese or lean men and women to a similar extent through potentially unique mechanisms. In contrast, energy restriction produces only mild reductions in postprandial lipemia suggesting that exercise may be superior to energy restriction alone as a strategy for lowering postprandial lipemia. However, isoenergetic very low-carbohydrate diets and n-3 fatty acid supplementation reduce postprandial lipemia indicating that macronutrient manipulations reduce postprandial lipemia in the absence of energy restriction. Therefore, interactions between exercise/energy restriction and alterations in macronutrient content remain top priorities for the field to identify optimal behavioral treatments to reduce postprandial lipemia.
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Chronic hyperglycaemia, confirmed with HbA1c levels, is a leading cause of diabetic complications. Recent studies point to a significant effect of postprandial glycaemia which results from an impaired ability of early secretion of insulin in type II diabetes. Postprandial hyperglycaemia is a frequent phenomenon in people with diabetes with satisfactory control of diabetes based on checks of HbA1c levels. Many authors demonstrate statistically more significant correlations between postprandial hyperglycaemia and HbA1c levels, compared to correlation of fasting glycaemia. Monitoring of postprandial glycaemia is a significant means for improving co-operation with a patient and provides a physician with a possibility of choice between an appropriate type of peroral antidiabetic or insulin.
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Objective To investigate the correlation of the elderly postprandial hypotension and vascular endothelial function.Methods 270 cases of elderly postprandial hypotension in elderly outpatients of our hospital were as experimental group,120 cases of healthy were as control group.Correlation of the elderly postprandial hypotension with von willebrand factor(vwF) and fibrinogen(Fbg) was analyzed.Results Hypotension after breakfast were 120 cases,105 cases were in postprandial hypotension,hypotension after dinner were of 45 cases,expression of vwF and Fbg in the experimental group compared with the control group,all had a significant difference(P 0.05).The expression of vwF and Fbg with postprandial hypotension had positive correlation(r = 0.589,0.603,P 0.05).Conclusion The expression of vwF and Fbg in the elderly postprandial were significantly increased,the elderly postprandial hypotension with vwF and Fbg have positive correlation.This can provide new methods and basis for the treatment of elderly postprandial hypotension.
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SUMMARY The description of a patient with the irritable bowel syndrome whose symptoms were completely relieved by the administration of somatostatin raised the possibility that a deficiency of somatostatin may be involved in the pathogenesis of the disorder. We have examined this possibility by studying 11 healthy controls (35 ± 12 years; mean ± S.D. 8 female) and 10 irritable bowel syndrome patients (39 ± 14 years; 7 female) complaining of frequency of defaecation of 4 or more times a day. Plasma somatostatin concentrations were determined by specific radioimmunoassay, fasting and at 15, 30, 45, 60, 90, 120 and 180 min after a standard breakfast. Irritable bowel syndrome patients and controls had similar fasting (27.4 ± 5.1 vs . 35.2 ± 4.3 pg/ml; mean ± S.E.M. and integrated increment of post‐prandial (5105 ± 858 vs . 3885 ± 793 pg. min/L) plasma concentrations of somatostatin, as assessed by student's t ‐test. These observations do not support the idea that a state of somatostatin deficiency exists in the irritable bowel syndrome.
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