Serum gastrin levels in patients with inflammatory bowel disease

The aim of this study was to estimate the levels of serum gastrin in a group of patients with either ulcerative colitis or Crohn's disease and to compare the results with those of a group of normal controls. In 108 consecutive patients with IBD (66 with ulcerative colitis, 32 with Crohn's disease and 10 with indetermined colitis) serum levels of gastrin were measured by radioimmunoassay. One hundred and eight normal people were served as controls. The levels of serum gastrin were significantly elevated in patients with Crohn's disease compared to normal controls (74.4 +/- 43.9 pg/ml vs. 47.5 +/- 32.4 pg/ml, P<0.05), irrespectively of the activity of the disease. On the contrary, patients with ulcerative colitis exhibited no significant differences compared to normal controls. Differences between Crohn's disease and ulcerative colitis patients were statistically significant (P<0.001). The rate of infection by Helicobacter pylori in patients with inflammatory bowel disease was statistically significantly lower as compared with normal controls (31.7% vs. 55.1%, P<0.001). It is concluded that patients with active or inactive Crohn's disease have increased levels of serum gastrin. This may have implications concerning the high incidence of upper GI lesions found in patients with Crohn's disease despite the very low incidence of Helicobacter pylori infection.     

Serum gastrin levels and colorectal neoplasia

PURPOSE: Confirmation of an association between elevated serum gastrin concentrations and presence of colorectal tumors would have important implications with regard to screening procedures and therapeutic strategies. METHODS: We compared fasting serum gastrin concentrations of patients with colorectal cancer (n=91; mean age, 66 (range, 35–87) years), colorectal polyps (n=89; mean age, 61 (range, 38–86) years), or a normal colonoscopy (n = 101; mean age, 62 (range, 34–82) years) in the period between 1983 and 1992. RESULTS: Median serum gastrin concentrations were, respectively, 20, 20, and 21 pmol/liter (not significant). We were unable to find a relation with histology of the polyp, presence or severity of dysplasia, and extent of cancer. CONCLUSIONS: This large study fails to show any difference in serum gastrin concentrations among the three studied groups.Read at the American Gastroenterological Association meeting of the Digestive Disease Week, New Orleans, Louisiana, May, 1994.     

Serum gastrin levels in patients with thyroid dysfunction

Fasting serum gastrin levels measured by radioimmunoassay were found to be elevated in patients with hyperthyroidism and low in patients with hypothyroidism. The oral administration of beef extracts resulted in more increase of serum gastrin in hyperthyroid patients than in normal subjects. After restoration of the euthyroid state by treatment, no more increase in serum gastrin levels was observed. Slight correlation between gastrin levels and serum T3 levels was observed in pretreated hyperthyroid patients (r = 0.40), but significant correlation between them was found after restoration of the euthyroid state by treatment (r = 0.50). However, it seemed to be able to divide into two groups in the pretreated patients. One was a patient group whose gastrin levels correlated closely to serum T3 levels (r = 0.83, p less than 0.01). The other was a group whose serum gastrin levels remained in low even in high T3 levels (r = 0.81, p less than 0.01). Different sensitivity to thyroid hormone in the G-cells of gastrointestinal tract may exist in these two groups, because patients age and duration of their illness were not different between them.     

Serum gastrin in patients with acute kidney failure

In 18 patients with acute renal failure and 11 patients with chronic renal insufficiency serum gastrin levels were estimated before and after a test meal. The results were compared with those obtained in a group of 52 healthy subjects. It was stated that patients with acute as well as chronic renal failure display a "physiological" increase of serum gastrin after stimulation by a test meal. In contrast to healthy subjects the post-test meal gastrin curves in patients with chronic and acute renal insufficiency during the anuric/oliguric phase started from significantly higher fasting values. From the results obtained it seems that diminished renal clearance of gastrin by the insufficient kidneys is only partially responsible for the elevated fasting values found in anuric/oliguric patients with acute renal failure or patients with chronic renal insufficiency.     

Serum gastrin response to secretin after vagotomy

It is unknown whether the gastrin response to secretin (secretin test) can distinguish hypergastrinemia due to vagotomy from hypergastrinemia due to Zollinger-Ellison syndrome (ZES). Therefore, we measured serum gastrin concentrations basally and in response to intravenous secretin in 13 vagotomized duodenal ulcer patients without preoperative evidence of ZES and in 5 vagotomized patients with ZES. Following secretin, serum gastrin concentrations increased 40 pg/ml or less [mean (± SE) rise 23±3 pg/ml] in the vagotomized patients without ZES. On the other hand, in the patients with ZES serum gastrin increments after secretin ranged from 105 to 1224 pg/ml. Thus, a large (>100 pg/ml) rise in serum gastrin concentrations following secretin in a vagotomized patient should suggest Zollinger-Ellison syndrome and not be attributed to vagotomyper se.Supported by Research Grants AM16816, AM17328 (to the Center for Ulcer Research & Education), and AM17294 from the National Institutes of Arthritis, Metabolism, and Digestive Diseases and a grant from Southwestern Medical Foundation's Kinsler Williamson Brown Fund, Dallas, Texas.     

Serum levels of gastrin in patients with colorectal neoplasia

Serum concentration of gastrin determined by radioimmunoassay in 90 consecutive patients who underwent colonoscopy, and serum levels of gastrin in patients with colorectal neoplasia and controls were compared. Based on clinical history, findings of colonoscopy, and pathologic examinations of biopsies, 80 patients were considered eligible for the study. Serum levels of gastrin in 36 controls were 54.1 +/- 13.1 pg/ml and did not differ from serum levels of gastrin in 44 patients with colorectal neoplasia. There was also no significant difference in serum levels of gastrin among 28 patients with adenomas and 16 patients with carcinoma. The present study disclosed that carcinogenesis of the colon and rectum was not associated with hypergastrinemia.     

Serum gastrin values in patients with familial adenomatous polyposis

PURPOSE: An evaluation of the importance of gastrin in the colorectal carcinogenesis in patients with familial adenomatous polyposis was conducted. METHODS: Blood samples from 168 family members of 26 families were investigated for circulating gastrin. Blood was drawn from 65 affected patients, 66 clinically unaffected first-degree relatives, and 37 spouses. RESULTS: We did not find any difference in distribution of serum gastrin among these groups. CONCLUSION: Our results seem to exclude gastrin from being relevant in early carcinogenesis in patients with familial adenomatous polyposis.     

Antral gastrin concentration in upper-gastrointestinal disease

Antral gastrin concentration (AGC) was measured in prepyloric mucosa specimens obtained by forceps biopsy during endoscopic examination of 174 clinic and hospital patients. AGC in 32 patients who had normal endoscopic findings, the control group, varied widely from 2 to 38.6 ng gastrin/mg tissue. The mean AGC of the control patients was 14.2±1.4 (mean ±1se) ng gastrin/mg tissue. AGC was similar to control values in 18 patients with duodenal ulcer, 14.7±2.1; 12 patients with a pyloric channel or antral ulcer, 16.4±3.5; and 48 patients with miscellaneous diagnoses, 14.3±1.5 AGC was significantly less than control values in 13 patients with a ulcer in the body or fundus of the stomach, 5.9±1.5, and 4 patients with the Zollinger-Ellison syndrome, 4.9±2.4. AGC was significantly greater than in control values in 16 patients with gastritis, 25.8±4.3; 22 patients with esophagitis, 23.2±3.0; and 9 patients with gastric atrophy and fasting serum hypergastrinemia 44.6±12.3. In a group of 77 of these patients with heterogeneous diagnoses, meal-stimulated 3-hr integrated gastrin output was directly related to AGC (r=0.47,P<0.001). In a group of 106 patients AGC was inversely related to histalogstimulated maximum acid output. The correlation was very weak (r=–0.20) but significant (P<0.05).Supported in part by Clinical Research Center grant RR-00073, U.S. Publich Health Service, Washington, D.C.This work was presented in part at the midwestern meeting of The American Federation of Clinical Research, October 31, 1974, and at the Annual Meeting of the American Federation for Clinical Research, Atlantic City, N.J., May 3, 1975.     

Serum gastrin responses to bombesin and food in patients with hypergastrinemia

Serum gastrin responses to bombesin and to food wer studied in patients with hypergastrinemia. Nine unoperated patients with hypergastrinemia of antral origin (seven achlorhydria and two idiopathic G-cell hyperfunction) had significantly higher serum gastrin responses to bombesin (P<0.001) and to food (P<0.001) than eight unoperated patients with Zollinger-Ellison syndrome. Three gastrectomized Zollinger-Ellison patients showed large serum gastrin responses to bombesin, and two of them had large postprandial increases in serum gastrin. Serum gastrin in a single patient with retained excluded antrum in the duodenal stump after partial gastrectomy with Billroth II anastomosis responded to bombesin but not to food. In nonoperated patients with hypergastrinemia of antral origin, the serum gastrin responses to bombesin and to food were significantly correlated (r=0.786;P<0.02) while in unoperated Zollinger-Ellison patients no such correlation was found (r=0.095;P>0.10). It is concluded that determination of the serum gastrin response to bombesin does not provide more information than measurement of postprandial serum gastrin concentrations in the differential diagnosis of patients with basal hypergastrinemia.     

Serum gastrin and serum calcitonin in patients with chronic renal failure.

The interrelationship between serum gastrin and serum calcitonin concentrations was studied in 73 patients with chronic renal failure. In both haemodialyzed and non-dialyzed patients increased serum concentrations of these hormones were found compared with normal controls. In non-dialyzed patients with creatinine clearance above 10 ml/min a highly significant correlation between serum gastrin and creatinine clearance was found, whereas no correlation was found in patients with creatinine clearance below 10 ml/min. Between serum gastrin and serum calcitonin, a significant positive correlation was found in non-dialyzed patients. These findings may be explained by a relationship between the two hormones or be secondary to a decreased elimination due to the reduced renal function.