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Postprandial GLP-1, Norepinephrine, and Reactive Hypoglycemia in Dumping Syndrome
Abstract
Rapid gastric emptying and exaggerated plasma concentrations of the insulinotropic hormone GLP-1 precede reactive hypoglycemia after oral glucose in gastrectomy patients. We suspected that the plasma volume drop associated with rapid gastric emptying (early dumping) would be accompanied by elevated plasma concentrations of norepinephrine. In order to study any relationship between postprandial norepinephrine, the enteroinsular axis, and plasma glucose, twelve patients with dumping syndrome and nine controls were studied. The plasma concentrations of norepinephrine, GLP-1, GIP, glucagon, insulin, and glucose were measured following a 1.5 g/kg lean body mass glucose meal. The early (0-30 min) integrated norepinephrine concentration was significantly higher in dumpers (22.1 +/- 3.8 nmol/ml/min) compared to controls (14.7 +/- 3.1 nmol/ml/min; P < 0.001) and correlated closely with the postprandial hematocrit increment (r = 0.71; P < 0.05). Early immunoreactivities of GLP-1, GIP, and glucagon peaked 30 min after glucose ingestion and were significantly higher in dumpers. Insulin peaked after 60 min and correlated with early GLP-1. In 11 of the patients glucose fell below baseline after a median interval of 120 min. Glucose at 120 min, when most of the nadirs occurred was lowest in patients with high early GLP-1 concentrations (r = 0.78; P < 0.001). Gel filtration chromatography of the dumpers' plasma revealed that pancreatic glucagon was detectable at time 0 and after 20 min, but…
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In alimentary RH, rapid gastric emptying and increased plasma GLP-1 levels precede RH after oral glucose loading in gastrectomy patients.
“In alimentary RH, rapid gastric emptying and increased plasma GLP-1 levels precede RH after oral glucose loading in gastrectomy patients,[4]”
From Postprandial Reactive Hypoglycemia (2019) · cites this paper as [4]
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“In alimentary RH, rapid gastric emptying and increased plasma GLP-1 levels precede RH after oral glucose loading in gastrectomy patients,[4] most patients with idiopathic RH have a delayed insulin secretion that occurs inappropriately in conjunction with falling levels of plasma glucose.”
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Metadata
- Authors
- Gebhard, B., Holst, J. J., Biegelmayer, C., & Miholic, J.
- Affiliations
- University of Vienna (AT)
- University of Copenhagen (DK)
- ORCID
- Holst, J.J.
- Venue
- Digestive Diseases and Sciences
- Published
- 2001-09
- Volume
- 46
- Issue
- 9
- Pages
- 1915-1923
- ISSN
- 0163-2116 (ISSN-L)
- 1573-2568
- OpenAlex
- W1565673342
- Cited by
- 92
- References
- 27
- Citations by year
- 2026: 2 · 2025: 2 · 2024: 2 · 2023: 3 · 2022: 2 · 2021: 2 · 2020: 2 · 2019: 3 · 2017: 3 · 2016: 4 · 2015: 4 · 2014: 7 · 2013: 5 · 2012: 6
- FWCI
- 2.31
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- Locations
- Digestive Diseases and Sciences (publishedVersion)
- PubMed (publishedVersion)
- Research at the University of Copenhagen (University of Copenhagen) (submittedVersion)
- Topics
- Health Sciences › Medicine › Surgery › Bariatric Surgery and Outcomes
- Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Keywords
- dumping syndrome, reactive hypoglycemia, glucagon-like peptide-1, norepinephrine, rapid gastric emptying, gastrectomy, glucagon, insulin, postprandial blood glucose, enteroinsular axis, catecholamines, hematocrit
- MeSH terms
- Chromatography, Gel, Dumping Syndrome, Glucagon, Hematocrit, Humans, Hypoglycemia, Middle Aged, Norepinephrine, Peptide Fragments, Protein Precursors, Postprandial Period, Glucagon-Like Peptide 1
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