GLP-2 levels in infants with intestinal dysfunction
GLP-2 levels in infants with intestinal dysfunction
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DOI：
10.1203/01.pdr.0000134250.80492.ec
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发表时间：
2004-09-01
影响因子：
3.6
通讯作者：
Holst, JJ
中科院分区：
文献类型：
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作者：
Sigalet, DL;Martin, G;Holst, JJ
胰高血糖素样肽2（GLP-2）已被认为是营养吸收的重要调节激素。本研究在接受手术的肠功能障碍婴儿中进行，将餐后GLP-2水平与肠道长度、营养吸收和患者结局相关。我们假设GLP-2水平与营养吸收呈负相关;我们进一步假设餐后GLP-2水平可预测患者从全肠外营养（TPN）中断奶的能力和肠内喂养的耐受性。对肠道手术后前瞻性发现营养吸收不良的婴儿进行监测，并在开始喂食后测量进食状态下的GLP-2水平。术中记录肠道长度，并使用平衡研究和碳水化合物探针法定量营养吸收。12名婴儿成功测量了GLP-2水平; 2名患者进行了重复研究。平均胎龄为32.7 +/- 3.4周，测试时年龄为1.7 +/- 1.4个月，平均体重为3.5 +/- 1.1 kg。肠丢失的原因是坏死性小肠结肠炎、闭锁和肠扭转。5名患者患有严重短肠综合征（15 pmol/L），能够脱离全肠外营养，而GLP-2水平低于15的4名婴儿中有3名无法在1年内断奶。这些结果表明，在患有肠功能障碍的婴儿中，GLP-2水平与残余小肠长度和营养吸收相关，并且可以预测结果。与结肠完整和SBS的成人相比，SBS和结肠完整的婴儿似乎不能产生GLP-2以响应喂养刺激。建议进一步研究以检查GLP-2轴的个体发育和GLP-2补充的可能治疗作用。
Glucagon Like Peptide 2 (GLP-2) has been proposed as an important regulatory hormone in nutrient absorption. The present study was conducted in human infants with intestinal dysfunction undergoing surgery, correlating postprandial GLP-2 levels with intestinal length, nutrient absorption, and patient outcome. We hypothesized that GLP-2 levels would be inversely related to nutrient absorption; we further hypothesized that post prandial GLP-2 levels would be predictive of the ability to wean patients from total parenteral nutrition (TPN), and tolerance of enteral feeding. Infants prospectively identified with nutrient malabsorption following intestinal surgery were monitored and after initiation of feeds GLP-2 levels were measured in the fed state. Intestinal length was recorded intraoperatively and nutrient absorption was quantified using both a balance study, and carbohydrate probe method. 12 infants had GLP-2 levels successfully measured; two patients had repeated studies. Average gestational age was 32.7 +/- 3.4 wk, age at testing was 1.7 +/- 1.4 mo and average weight was 3.5 +/- 1.1 kg. Causes of intestinal loss were necrotizing enterocolitis, atresia and volvulus. Five patients had severe short bowel syndrome ( 15 pmol/L were able to be weaned from total parenteral nutrition, while 3 of 4 infants who had GLP-2 levels less than 15 could not be weaned by one year. These results show that in infants with intestinal dysfunction, GLP-2 levels are correlated with residual small bowel length and nutrient absorption, and may be predictive of outcome. In contrast to adults with intact colon and SBS, infants with SBS and intact colon do not appear able to produce GLP-2 in response to feeding stimulation. Further studies are suggested to examine the ontogeny of the GLP-2 axis and the possible therapeutic role of GLP-2 supplementation.