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THE INFLUENCE OF ADRENERGIC DENERVATION ON THE RESPONSE TO FEEDING OF THE GASTROENTEROPANCREATIC SYSTEM IN MAN

The effect of adrenergic denervation on the metabolic and hormonal responses to a standard meal was studied in six tetraplegic subjects (pre‐ganglionic sympathectomy) and compared with six normal subjects. Gastric emptying, estimated by isotope scintiscanning, was similar in both groups. Following the meal the mean blood glucose and plasma insulin rose in both groups, but were higher and remained elevated for longer in the tetraplegic subjects. There were no significant differences in the secretion of pancreatic glucagon, enteroglucagon, gastric inhibitory peptide (GIF) and neurotensin between the two groups. The mean basal and post‐prandial levels of pancreatic polypeptide and motilin were significantly higher in the tetraplegic group. This study confirms the presence of mild glucose intolerance in tetraplegic subjects which is not explicable on the basis of abnormal insulin or pancreatic glucagon secretion or abnormal gastric emptying. In addition the results provide evidence for a sympathetic inhibitory influence on the secretion of pancreatic polypeptide and motilin in man, which is probably adrenergically‐mediated.