Cholecystokinin secretion is suppressed by glucagon-like peptide-1: clue to the mechanism of the adverse gallbladder events of GLP-1-derived drugs |
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Authors: | Jens F. Rehfeld Filip K. Knop Ali Asmar Sten Madsbad Jens J. Holst Meena Asmar |
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Affiliation: | 1. Department of Clinical Biochemistry, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark;2. jens.f.rehfeld@regionh.dk;4. Steno Diabetes Center, Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark;5. Department of Clinical Physiology, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark;6. Department of Endocrinology, Hvidovre Hospital, University of Copenhagen, Copenhagen, Denmark;7. Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark;8. Department of Endocrinology, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark |
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Abstract: | AbstractObjective: Recent randomized and controlled trials of drugs derived from the gut hormone glucagon-like peptide-1 (GLP-1) show that the most frequent adverse symptoms are gastrointestinal, including gallbladder-related side effects such as cholithiasis and cholecystitis. Since the gut hormone cholecystokinin (CCK) stimulates bile secretion and regulates gallbladder motility and emptying, we examined the effect of GLP-1 on the secretion of CCK in normal subjects and patients with type 1 diabetes mellitus.Materials and methods: Plasma was sampled from 10 healthy subjects and 10 patients with diabetes. With plasma glucose concentrations clamped between 6 and 9?nmol/l, GLP-1 or saline was infused for 240?min during and after a meal. The plasma concentrations of CCK were measured with a highly specific radioimmunoassay.Results: Basal plasma concentrations of CCK were similar in the normal subjects and in the diabetes patients. During the meal, the CCK concentrations rose significantly during saline infusion, whereas the GLP-1 infusion suppressed the secretion of CCK significantly in both normal subjects and in the diabetes patients.Conclusions: The results show that GLP-1 suppresses the secretion of CCK after a meal in normal and diabetic subjects. The suppression attenuates the gallbladder contractility. Our data, therefore, offer an explanation for the increased risk of adverse gallbladder events during treatment with GLP-1-derived drugs. |
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Keywords: | Cholecystokinin cholecystitis cholelithiasis diabetes mellitus glucagon-like peptide 1 side effects |
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