Ghrelin enhances gastric emptying in diabetic gastroparesis: a double blind, placebo controlled, crossover study.

Abstract

BACKGROUND:

Diabetic gastroparesis is a disabling condition with no consistently effective treatment. In animals, ghrelin increases gastric emptying and reverses postoperative ileus. We present the results of a double blind, placebo controlled, crossover study of ghrelin in gastric emptying in patients with diabetic gastroparesis.

METHODS:

Ten insulin requiring diabetic patients (five men, six type I) referred with symptoms indicative of gastroparesis received a two hour infusion of either ghrelin (5 pmol/kg/min) or saline on two occasions. Blood glucose was controlled by euglycaemic clamp. Gastric emptying rate (GER) was calculated by real time ultrasound following a test meal. Blood was sampled for ghrelin, growth hormone (GH), and pancreatic polypeptide (PP) levels. Cardiovagal neuropathy was assessed using the Mayo Clinic composite autonomic severity score (range 0 (normal)-3).

RESULTS:

Baseline ghrelin levels were mean 445 (SEM 36) pmol/l. Ghrelin infusion achieved a peak plasma level of 2786 (188) pmol/l at 90 minutes, corresponding to a peak GH of 70.9 (19.8) pmol/l. Ghrelin increased gastric emptying in seven of 10 patients (30 (6)% to 43 (5)%; p = 0.04). Impaired cardiovagal tone correlated inversely with peak postprandial PP values (p < 0.05) but did not correlate with GER.

CONCLUSIONS:

Ghrelin increases gastric emptying in patients with diabetic gastroparesis. This is independent of vagal tone. We propose that analogues of ghrelin may represent a new class of prokinetic agents.

• Authors: C D R Murray, N M Martin, M Patterson, S A Taylor, M A Ghatei, M A Kamm, C Johnston, S R Bloom, A V Emmanuel
• Journal: Gut (Gut) Vol. 54 Issue 12 Pg. 1693-8 (Dec 2005) ISSN: 0017-5749 [Print] England
• PMID: 16085693 (Publication Type: Journal Article, Randomized Controlled Trial)

Chemical References

• Ghrelin
• Peptide Hormones

Topics

• Adult
• Cross-Over Studies
• Diabetes Complications (diagnostic imaging, drug therapy, physiopathology)
• Double-Blind Method
• Drug Administration Schedule
• Female
• Gastric Emptying (drug effects)
• Gastroparesis (diagnostic imaging, drug therapy, physiopathology)
• Ghrelin
• Humans
• Male
• Middle Aged
• Peptide Hormones (blood, therapeutic use)
• Stomach (diagnostic imaging)
• Ultrasonography