Nutrients and cyclical interdigestive pancreatic enzyme secretion in humans. 1996

G Holtmann, and D G Kelly, and E P DiMagno
Division of Gastroenterology, Mayo Clinic and Mayo Foundation, Rochester, Minnesota, USA.

OBJECTIVE It is hypothesised that nutrients increase pancreatic enzyme secretion by converting cyclical interdigestive secretion to a non-cyclical pattern. This study tested the hypotheses that nutrients do not interrupt cycles and determined the relation of nutrients, calories, and osmotic load to the rate of pancreatic secretion. METHODS Twenty six healthy persons were intubated with oroduodenal and orogastric tubes. Each had one of four different solutions containing 12 to 36% of calories as protein, 24 to 48% as fat, and 40 to 64% as carbohydrate infused into the duodenum at 40, 90, or 160 kcal/h for 300 minutes. Nine g/l sodium chloride (290 mOsm) was added to 16 infusates; osmolality of the other 10 infusates was 24 to 98 mOsm. Pancreatic enzyme outputs were measured every 15 minutes and peaks of enzyme secretion were identified. RESULTS The number of enzyme peaks was similar for the different infusates and the proportion of nutrients in the infusates did not affect secretion of individual enzymes. The nadir, but not the peak of the cycles of enzyme outputs correlated with increasing the caloric load (r = 0.55, p < 0.003 for nadir:peak ratio). Increasing osmolality did not affect cycling but reduced (p < 0.001) enzyme output. CONCLUSIONS Nutrients entering the duodenum do not abolish cycles of enzyme secretion; instead they modulate cycles by increasing the nadir. Forty and 90 kcal infusions submaximally stimulate pancreatic secretion and might be used in patients with pancreatitis without producing pain; adding sodium chloride to solutions should increase this effect.

UI MeSH Term Description Entries
D010179 Pancreas A nodular organ in the ABDOMEN that contains a mixture of ENDOCRINE GLANDS and EXOCRINE GLANDS. The small endocrine portion consists of the ISLETS OF LANGERHANS secreting a number of hormones into the blood stream. The large exocrine portion (EXOCRINE PANCREAS) is a compound acinar gland that secretes several digestive enzymes into the pancreatic ductal system that empties into the DUODENUM.
D010288 Parenteral Nutrition The administering of nutrients for assimilation and utilization by a patient who cannot maintain adequate nutrition by enteral feeding alone. Nutrients are administered by a route other than the alimentary canal (e.g., intravenously, subcutaneously). Intravenous Feeding,Nutrition, Parenteral,Parenteral Feeding,Feeding, Intravenous,Feeding, Parenteral,Feedings, Intravenous,Feedings, Parenteral,Intravenous Feedings,Parenteral Feedings
D011897 Random Allocation A process involving chance used in therapeutic trials or other research endeavor for allocating experimental subjects, human or animal, between treatment and control groups, or among treatment groups. It may also apply to experiments on inanimate objects. Randomization,Allocation, Random
D002918 Chymotrypsin A serine endopeptidase secreted by the pancreas as its zymogen, CHYMOTRYPSINOGEN and carried in the pancreatic juice to the duodenum where it is activated by TRYPSIN. It selectively cleaves aromatic amino acids on the carboxyl side. Alpha-Chymotrypsin Choay,Alphacutanée,Avazyme
D003500 Cyclization Changing an open-chain hydrocarbon to a closed ring. (McGraw-Hill Dictionary of Scientific and Technical Terms, 5th ed) Cyclizations
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D006867 Hydrolases Any member of the class of enzymes that catalyze the cleavage of the substrate and the addition of water to the resulting molecules, e.g., ESTERASES, glycosidases (GLYCOSIDE HYDROLASES), lipases, NUCLEOTIDASES, peptidases (PEPTIDE HYDROLASES), and phosphatases (PHOSPHORIC MONOESTER HYDROLASES). EC 3. Hydrolase
D000681 Amylases A group of amylolytic enzymes that cleave starch, glycogen, and related alpha-1,4-glucans. (Stedman, 25th ed) EC 3.2.1.-. Diastase,Amylase
D014357 Trypsin A serine endopeptidase that is formed from TRYPSINOGEN in the pancreas. It is converted into its active form by ENTEROPEPTIDASE in the small intestine. It catalyzes hydrolysis of the carboxyl group of either arginine or lysine. EC 3.4.21.4. Tripcellim,Trypure,beta-Trypsin,beta Trypsin

Related Publications

G Holtmann, and D G Kelly, and E P DiMagno
September 1992, Gastroenterology,
G Holtmann, and D G Kelly, and E P DiMagno
January 1982, Revista de investigacion clinica; organo del Hospital de Enfermedades de la Nutricion,
G Holtmann, and D G Kelly, and E P DiMagno
March 1993, Pancreas,
G Holtmann, and D G Kelly, and E P DiMagno
December 1986, Archives internationales de physiologie et de biochimie,
G Holtmann, and D G Kelly, and E P DiMagno
May 1985, Digestive diseases and sciences,
G Holtmann, and D G Kelly, and E P DiMagno
December 1990, Gastroenterology,
G Holtmann, and D G Kelly, and E P DiMagno
March 1994, Annals of the New York Academy of Sciences,
G Holtmann, and D G Kelly, and E P DiMagno
April 1981, Gastroenterology,
G Holtmann, and D G Kelly, and E P DiMagno
September 1986, Archives internationales de physiologie et de biochimie,
G Holtmann, and D G Kelly, and E P DiMagno
July 1992, Gaoxiong yi xue ke xue za zhi = The Kaohsiung journal of medical sciences,
Copied contents to your clipboard!