Do the Actions of Glucagon-Like Peptide-1 on Gastric Emptying, Appetite, and Food Intake Involve Release of Amylin in Humans?

Mar 3, 2010The Journal of clinical endocrinology and metabolism

Do glucagon-like peptide-1 effects on stomach emptying, hunger, and eating involve amylin release in humans?

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Abstract

In patients with type 1 diabetes, gastric emptying, food intake, and appetite were reduced equally during low GLP-1 and amylin infusion compared with saline infusion (P < 0.05).

GLP-1 infusion resulted in stronger suppression of gastric emptying and food intake in healthy controls compared to amylin.
Postprandial glucagon responses were decreased in both healthy controls and patients with type 1 diabetes during GLP-1 and amylin infusions.
Amylin and pramlintide infusion produced similar effects on gastric emptying and appetite.
The effects of GLP-1 on gastric emptying, appetite, food intake, and glucagon secretion may occur directly, with amylin potentially contributing in healthy subjects.

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OBJECTIVE: Amylin, cosecreted with insulin, has like glucagon-like peptide-1 (GLP-1) been reported to inhibit glucagon secretion, delay gastric emptying, and reduce appetite and food intake. We investigated whether the effects of GLP-1 on gastric emptying, appetite, and food intake are mediated directly or indirectly via release of amylin.

DESIGN: Eleven C-peptide and amylin-negative patients with type 1 diabetes mellitus (T1DM) and 12 matched healthy controls participated in a placebo-controlled, randomized, single-blinded, crossover study. With glucose clamped between 6 and 9 mm, near-physiological infusions of GLP-1, human amylin, pramlintide, or saline were given for 270 min during and after a fixed meal. Gastric emptying was measured using paracetamol, appetite using visual analog scales, and food intake during a subsequent ad libitum meal (at 240 min).

RESULTS: In T1DM, gastric emptying, food intake, and appetite were reduced equally during low GLP-1 and amylin infusion compared with the saline infusion (P < 0.05). The controls showed stronger suppression of gastric emptying (P < 0.0001) and food intake (P < 0.01) with GLP-1 compared to amylin. Postprandial glucagon responses were reduced in controls and T1DM during GLP-1 and amylin infusions (P < 0.05). Amylin and pramlintide infusion had similar effects.

CONCLUSIONS: GLP-1 exerts its effect on gastric emptying, appetite, food intake, and glucagon secretion directly, although secretion of amylin may contribute to some of these effects in healthy control subjects.

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Do the Actions of Glucagon-Like Peptide-1 on Gastric Emptying, Appetite, and Food Intake Involve Release of Amylin in Humans?

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