Effects of dipeptidyl peptidase IV inhibition on glycemic, gut hormone, triglyceride, energy expenditure, and energy intake responses to fat in healthy males

Fat is the most potent stimulus for glucagon-like peptide-1 (GLP-1) secretion. The aims of this study were to determine whether dipeptidyl peptidase IV (DPP-IV) inhibition would enhance plasma active incretin [glucose-dependent insulinotropic polypeptide (GIP), GLP-1] concentrations and modulate the glycemic, gut hormone, triglyceride, energy expenditure, and energy intake responses to intraduodenal fat infusion. In a double-blind, randomized, placebo-controlled crossover design, 16 healthy lean males received 50 mg vildagliptin (V), or matched placebo (P), before intraduodenal fat infusion (2 kcal/min, 120 min). Blood glucose, plasma insulin, glucagon, active GLP-1, and GIP and peptide YY (PYY)-(3-36) concentrations; resting energy expenditure; and energy intake at a subsequent buffet meal (time = 120-150 min) were quantified. Data are presented as areas under the curve (0-120 min, means ± SE). Vildagliptin decreased glycemia (P: 598 ± 8 vs. V: 573 ± 9 mmol·l⁻¹·min⁻¹, P < 0.05) during intraduodenal lipid. This was associated with increased insulin (P: 15,964 ± 1,193 vs. V: 18,243 ± 1,257 pmol·l⁻¹·min⁻¹, P < 0.05), reduced glucagon (P: 1,008 ± 52 vs. V: 902 ± 46 pmol·l⁻¹·min⁻¹, P < 0.05), enhanced active GLP-1 (P: 294 ± 40 vs. V: 694 ± 78 pmol·l⁻¹·min⁻¹) and GIP (P: 2,748 ± 77 vs. V: 4,256 ± 157 pmol·l⁻¹·min⁻¹), and reduced PYY-(3-36) (P: 9,527 ± 754 vs. V: 4,469 ± 431 pM/min) concentrations compared with placebo (P < 0.05, for all). Vildagliptin increased resting energy expenditure (P: 1,821 ± 54 vs. V: 1,896 ± 65 kcal/day, P < 0.05) without effecting energy intake. Vildagliptin 1) modulates the effects of intraduodenal fat to enhance active GLP-1 and GIP, stimulate insulin, and suppress glucagon, thereby reducing glycemia and 2) increases energy expenditure. These observations suggest that the fat content of a meal, by enhancing GLP-1 and GIP secretion, may contribute to the response to DPP-IV inhibition.

Effect of gelatinisation of starch with casein proteins on incretin hormones and glucose transporters in vitro

Foods that have a low glycaemic index or foods that contain slowly digestible starch are beneficial in controlling fluctuations in blood glucose and insulin levels. The study hypothesis is that gelatinisation of starch in structured casein networks provides a method for decreasing the digestion rate of the starch and, hence, minimising postprandial glucose fluctuations. This study examined the effect of starch gelatinisation with or without casein on (1) gene expression and peptide secretion levels of the incretin hormones glucagon-like peptide 1 and glucose-independent insulinotropic polypeptide and (2) gene expression of the sodium–glucose cotransporter and GLUT-2 in intestinal cell culture systems. The intestinal epithelial cell line, STC-1, and the enteroendocrine colonic cell line, Caco-2, were exposed to in vitro digested foods (starch gelatinised with α-casein, starch gelatinised with β-casein and gelatinised starch alone). The encapsulation of starch with casein before in vitro digestion lowers levels of incretin hormone secretion. Digestion of starch gelatinised with casein also releases less glucose than starch alone as indicated by significantly (P < 0·05) lower levels of glucose transporter mRNA transcripts. Some subtle cellular response differences were observed following exposure to starch gelatinised with α- compared to β-casein. Fractionation of α-casein and β-casein by reverse-phase HPLC identified that fractions that differed in hydrophobicity differed significantly (P < 0·05) in their ability to promote secretion of the incretin hormones. Evidence suggests that gelatinisation of starch with casein may be a functional food ingredient that minimises blood glucose fluctuations.