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Worsening Postural Tachycardia Syndrome Is Associated With Increased Glucose-Dependent Insulinotropic Polypeptide Secretion, 2022, Nicholas C Breier

Discussion in 'Other health news and research' started by Mij, Mar 3, 2022.

  1. Mij

    Mij Senior Member (Voting Rights)

    Messages:
    8,352
    Abstract

    Background: Postural tachycardia syndrome (POTS) is characterized by excessive upright tachycardia and disabling presyncopal symptoms, which are exacerbated after consuming a high-carbohydrate meal; it is unknown, however, what is the precise underlying mechanism. We seek to investigate the effect of glucose intake on orthostatic hemodynamic changes and gastrointestinal hormone secretion in POTS.

    Methods: Prospective, case-control study, 12 women with POTS who reported a postprandial worsening of their POTS symptoms and 13 age-matched female controls received 75-g oral glucose and 20 mg/kg acetaminophen to assess nutrient absorption. Hemodynamic, gastrointestinal hormone and acetaminophen levels were measured for up to 120 minutes postingestion while supine and standing.

    Results: Patients with POTS had significant orthostatic tachycardia, 48.7±11.2 versus 23.3±8.1 bpm, P=0.012 and elevated upright norepinephrine levels, 835.2±368.4 versus 356.9±156.7 pg/mL, P=0.004. After oral glucose, upright heart rate significantly increased in POTS, 21.2±11.9% versus 6.0±19.9%, P=0.033 with a concomitant decline in upright stroke volume, -10.3±11.90% versus 3.3±13.7%, P=0.027; total peripheral resistance, blood pressure and cardiac output remained unaltered. Acetaminophen rate of appearance was similar between groups (P=0.707), indicating comparable nutrient absorption rates. POTS had increased plasma levels of C-peptide (P=0.001), GIP (glucose-dependent insulinotropic polypeptide; P=0.001), peptide YY (P=0.016), and pancreatic polypeptide (P=0.04) following glucose consumption, but only GIP had a time-dependent association with the worsening upright tachycardia and stroke volume fall.

    Conclusions: The glucose-induced worsening orthostatic tachycardia in POTS was associated with a decline in SV; these changes occurred while GIP, a splanchnic vasodilator, was maximally elevated.

    https://pubmed.ncbi.nlm.nih.gov/35232225/
     
    Mij, Mar 3, 2022
    #1
    Milo, Hutan, alktipping and 6 others like this.
  2. rvallee

    rvallee Senior Member (Voting Rights)

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    Location:
    Canada
    This seems significant.
     
    rvallee, Mar 3, 2022
    #2
    Hutan, alktipping and Peter Trewhitt like this.
  3. Hutan

    Hutan Moderator Staff Member

    Messages:
    27,065
    Location:
    Aotearoa New Zealand
    This study was mentioned at the IACFS/ME 2022 conference by Lauren Stiles of Dysautonomia International:
    I note from the abstract that this study was quite small (12 women with POTS), and they weren't a random sample of POTS patients. They were selected for the study because they reported post-prandial worsening of their POTS symptoms. That said, the study sounds interesting; there is a paywall.
     
    Hutan, Jul 31, 2022
    #3
    Lilas, Mij, Trish and 1 other person like this.

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