Increased postprandial response of glucagon-like peptide-2 in patients with chronic pancreatitis and pancreatic exocrine insufficiency.

Glucagon-like peptide-2 (GLP-2) is a nutrient-released gastrointestinal (GI) hormone that acts as an intestinal growth factor, and exogenous GLP-2 has been shown to increase superior mesenteric artery (SMA) blood flow. We aimed to investigate how assimilation of nutrients affects postprandial GLP-2 responses and to correlate these with postprandial SMA blood flow. Responses of the GI hormone glucose-dependent insulinotropic polypeptide (GIP) and GLP-2 were measured following an 80-min liquid meal test in 8 patients (6 males) with chronic pancreatitis (CP) and pancreatic exocrine insufficiency (PEI) and 8 healthy control subjects (5 males). Postprandial GI hormone responses were correlated with change in SMA flow as assessed by the resistance index. Patients with CP and PEI exhibited the greatest postprandial GLP-2 responses (1,870 +/- 249 vs. 1,199 +/- 108 pM.80 min, p = 0.027). No difference was observed with regard to GIP. GLP-2, but not GIP, responses correlated significantly with postprandial SMA flow. These results suggest that delayed assimilation of nutrients in patients with CP and PEI increases the secretion of GLP-2 - possibly due to delivery of a larger nutrient load to the distal part of the small intestine, where GLP-2 secreting L-cells are abundant - and that this hypersecretion of GLP-2 is associated with a higher SMA flow.