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1 Merck, Sharp and Dohme A/S
2 Novo Nordisk A/S
3 University of Lund
4 Panum Institute, University of Copenhagen
5 Lund University
* To whom correspondence should be addressed. E-mail: bo.ahren{at}med.lu.se.
Glucagon-like 1 peptide (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP) regulate islet function after carbohydrate ingestion. Whether incretin hormones are of importance for islet function after ingestion of non-carbohydrate macronutrients is not known. This study therefore examined the integrated incretin and islet hormone responses to ingestion of pure fat (oleic acid; 0.88 g/kg) or protein (milk and egg protein; 2 g/kg) over 5 hours in healthy men, aged 20-25 years (n=12); plain water ingestion served as control. Both intact (active) and total GLP-1 and GIP levels were determined as was plasma activity of dipeptidyl peptidase-4 (DPP-4). Following water ingestion, glucose, insulin, glucagon, GLP-1 and GIP levels and DPP-4 activity were stable during the 5 hour study period. Both fat and protein ingestion increased insulin, glucagon, GIP and GLP-1 levels without affecting glucose levels or DPP-4 activity. The GLP-1 responses were similar after protein and fat, whereas the early (30 min) GIP response was higher after protein than after fat ingestion (P<0.001). This was associated with seven-fold higher insulin and glucagon responses compared to fat ingestion (both P<0.001). After protein, the early GIP, but not GLP-1, responses correlated to insulin (r2=0.86; P=0.0001) but not glucagon responses. In contrast, after fat ingestion, GLP-1 and GIP did not correlate to islet hormones. We conclude that whereas protein and fat release both incretin and islet hormones, the early GIP secretion after protein ingestion may be of primary importance to islet hormone secretion.
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