Functional Correlation Between the Pancreas and the Small Intestine in Humans: The First Evaluation Using a Newly Developed Enteroscopy

Daijuro Hayashi, Yoshiki Hirooka, Hiroki Kawashima, Eizaburo Ohno, Takuya Ishikawa, Takamichi Kuwahara, Manabu Kawai, Takeshi Yamamura, Kazuhiro Furukawa, Kohei Funasaka, Masanao Nakamura, Ryoji Miyahara, Osamu Watanabe, Masatoshi Ishigami, Senju Hashimoto, Hidemi Goto

Research output: Contribution to journalArticle

Abstract

OBJECTIVES: The aim of this study is to evaluate a functional correlation between the pancreas and the small intestine and the association of this relationship with nutritional status, using magnifying enteroscopy.

METHODS: The subjects were adults aged 20 years or older who underwent upper gastrointestinal endoscopy. An endoscope was inserted into the jejunum, and 10% glucose was sprayed under magnifying observation to evaluate changes in blood flow in the villous capillary network. Mucosal biopsy was performed before and after spraying to evaluate the incretin response in the jejunal mucosa.

RESULTS: A total of 124 patients participated in the study. There was a positive correlation between villous blood flow change and exocrine pancreas function (R = 0.4337, P < 0.0001). Changes of gastric inhibitory polypeptide and glucagon-like peptide messenger RNAs in biopsy samples were positively correlated with endocrine pancreas function in 88 patients without treatment for diabetes (R = 0.4314, P = 0.0012; R = 0.4112, P = 0.0081). In patients with lower villous blood flow change and decreased pancreatic exocrine function, the prognostic nutritional index were significantly lower (P = 0.0098), compared with other patients.

CONCLUSIONS: This study provides the first evidence of a close functional correlation between the pancreas and the small intestine.

Original languageEnglish
Pages (from-to)601-608
Number of pages8
JournalPancreas
Volume47
Issue number5
DOIs
Publication statusPublished - 01-05-2018

All Science Journal Classification (ASJC) codes

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Hepatology
  • Endocrinology

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    Hayashi, D., Hirooka, Y., Kawashima, H., Ohno, E., Ishikawa, T., Kuwahara, T., Kawai, M., Yamamura, T., Furukawa, K., Funasaka, K., Nakamura, M., Miyahara, R., Watanabe, O., Ishigami, M., Hashimoto, S., & Goto, H. (2018). Functional Correlation Between the Pancreas and the Small Intestine in Humans: The First Evaluation Using a Newly Developed Enteroscopy. Pancreas, 47(5), 601-608. https://doi.org/10.1097/MPA.0000000000001039