Cholecystokinin and pancreatic polypeptide release in diabetic patients with and without autonomic neuropathy

The present study was undertaken to investigate postprandial responses of cholecystokinin (CCK) and pancreatic polypeptide (PP) and their interrelationship in patients with diabetes mellitus (DM) with and without autonomic neuropathy (AN). Twenty-two patients with DM (seven with AN and 15 without AN) and 14 age-matched healthy controls were studied. AN was diagnosed according to several tests of cardiovascular autonomic function. CCK and PP plasma levels were measured by specific radioimmunoassays before and at several time points after the oral administration of a test meal. Basal CCK plasma levels in DM patients were normal, whereas basal PP plasma levels were increased (139±18 vs 72±7 pg/ml;P<0.01). integrated=" postprandial=" cck=" response=" was=" increased=" in=" dm=" patients=" (208±27=" vs=" 110±14=" pmol/liter/2=">P<0.05), mainly=" due=" to=" the=" patients=" with=" an.=" postprandial=" pp=" response=" was=" increased=" in=" dm=" patients=" without=" an=" (37,273±5241=" vs=" 13,418±3299=" pg/ml/2=">P<0.001) but=" not=" in=" those=" with=" an=" (8887±3461=" pg/ml/2=" hr).=" moreover,=" pp=" response=" was=" closely=">P<0.002) correlated=" with=" the=" degree=" of=" an.=" a=" direct=" and=" linear=" correlation=" between=" postprandial=" cck=" and=" pp=" responses=" was=" found=" in=" healthy=" controls=">r=0.78;P<0.005) but=" not=" in=" dm=" patients.=" we=" conclude=" that=" the=" cck=" response=" to=" a=" meal=" is=" increased=" in=" diabetic=" patients=" with=" an,=" whereas=" the=" pp=" response=" is=" increased=" only=" with=" an=" intact=" autonomic=" nervous=" system.=" it=" is=" suggested=" that=" the=" correlation=" between=" postprandial=" hormonal=" responses=" in=" healthy=" subjects=" is=" due=" to=" the=" potency=" of=" cck=" as=" pp=" releasing=" agent=" and=" that=" this=" interaction=" does=" not=" work=" in=" diabetic=">