Abstract:

Context: The colon houses most of our gut microbiota, which ferments indigestible carbohydrates. The products of fermentation have been proposed to influence the secretion of glucagon-like peptide-1 (GLP-1) and peptide YY (PYY) from the many endocrine cells in the colonic epithelium. However, little is known about the colonic contribution to fasting or postprandial plasma levels of L-cell products. Objective: To determine the impact of colonic lactulose fermentation on gut peptide secretion and to evaluate whether colonic endocrine secretion contributes to gut hormone concentrations measurable in the fasting state. Research design and methods: Ten healthy young men were studied on three occasions after an overnight fast. On two study days, lactulose (20 g) was given orally, and compared to water intake on a third study day. For one of the lactulose visits participants underwent a full colonic evacuation. Over a six-hour study protocol, lactulose fermentation was assessed by measuring exhaled hydrogen (H2), while gut peptide secretion, paracetamol and short chain fatty acid levels were measured in plasma. Results: Colonic evacuation markedly reduced hydrogen exhalation after lactulose intake (p=0.013). Our analysis suggests that the colon does not account for the measurable amounts of GLP-1 and PYY present in the circulation during fasting, and that fermentation and peptide secretion are not acutely related. Conclusion: Whether colonic luminal contents affect colonic L-cell secretion sufficiently to influence circulating concentrations requires further investigation. Colonic evacuation markedly reduced lactulose fermentation, but hormone releases were unchanged in the present study.

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https://doi.org/10.1210/clinem/dgab666

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