Gut Hormone Levels During Mixed Liquid Meal Test in Short Bowel Syndrome, the Possible Influence on the Intestine Adaptation

Short bowel syndrome (SBS) is an intestinal disorder characterized by reduced length of the gut most due to intestinal resection, resulting in malabsorption, malnutrition, and water and electrolyte disturbances. Intestinal adaptation is a long-term process in which GIT hormones, growth peptides, cytokines etc. are involved. These mechanisms have not been fully clarified yet. The most important seem to be GLP-2 and other gut hormones. The aim of our study was to consider the changes of the levels of selected gut hormones and parameters of glucose homeostasis during the mixed liquid meal test in one year of follow up after the gut resection. Seventeen patients with SBS type I were included into our study. The meal test and measuring of selected parameters (GLP-2, GLP-1, ghrelin, insulin, glucagon, GIP, amylin) were conducted after 2 weeks, 6 and 12 months from its initiation, respectively. During one year of this study patients´ nutritional status improved due to sufficient parenteral nutrition, despite no change in body weight. Hormones possibly involved in intestinal adaptation (GLP-2, GLP-1, ghrelin) did not differ in meal test, neither levels nor AUC. Only higher insulin and glucose levels after one year of follow-up may indicate the beginning of intestinal adaptation process and improving intestinal functions. We conclude that impaired GLP-2 secretion is probably the main reason for the limited adaptation ability in patients with SBS type I.