Updated: 9/22/2018

Overview of GI Hormones

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Overview
 
Hormone
Source
Action Regulation Notes
Gastrin
  • G cells (stomach-antrum)
  • ↑ gastric H+ secretion
  • ↑ growth of gastric mucosa 
  • ↑ gastric motility
  • ↑ by stomach distension
  • ↑ by amino acids, small peptides
  • ↑ by vagal stimulation (GRP)
  • ↓ by stomach pH < 1.5
  • ↓ by somatostatin
  • ↑↑ in Zollinger-Ellison syndrome
  • Phenylalanine and tryptophan are potent stimulators
Cholecystokinin (CCK) 
  • I cells (duodenum, jejunum)
  • ↑ pancreatic secretion
  • ↑ gallbladder contraction and relaxation of sphincter of Oddi
  • ↓ gastric emptying
  • ↑ by amino acids, small peptides
  • ↑ by fatty acids
  • A patient with cholelithiasis (gallstones) experiences worsened pain after fatty food ingestion due to ↑ release of CCK 
Secretin 
  • S cells (duodenum)
  • ↑ pancreatic HCO3- secretion
  • ↑ biliary HCO3- secretion
  • ↓ gastric H+ secretion
  • ↑ by H+ in duodenum
  • ↑ by fatty acids in duodenum
  • ↑ HCO3- neutralizes gastric H+ in duodenum, essential for fat digestion (pancreatic lipases have pH optimums between 6 and 8)
Somatostatin
  • D cells ( GI mucosa)
  • delta cells (endocrine pancreas)
  • ↓ gastric H+ and pepsinogen secretion
  • ↓ pancreatic and small intestine fluid secretion
  • ↓ gallbladder contraction
  • ↓ insulin and glucagon release
  • ↑ by H+
  • ↓ by vagal stimulation
  • Inhibitory hormone
  • Antigrowth hormone effects (digestion and absorption of substances needed for growth)
  • Somatostatin is treatment for VIPoma and carcinoid tumors
Glucose-dependent insulinotropic peptide (GIP)
  • K cells (duodenum, jejunum)
  • exocrine: ↓ gastric H+ secretion
  • endocrine: ↑ insulin secretion by pancreatic beta cells
  • ↑ by fatty acids
  • ↑ by amino acids
  • ↑ by oral glucose
  • An oral glucose load is utilized by cells more rapidly than an equivalent IV glucose load
Vasoactive intestinal polypeptide (VIP)
  • parasympathetic ganglia in sphincters, gallbladder, and small intestine
  • ↑ intestinal water and electrolyte secretion
  • ↑ relaxation of intestinal smooth muscle and sphincters
  • ↑ by distention and vagal stimulation
  • ↓ by adrenergic input
  • VIPoma is a non-α, non-β islet cell pancreatic tumor that secretes VIP and causes copious diarrhea
Nitric oxide (NO)
-
  • ↑ smooth muscle relaxation ( lower esophageal sphincter)
 -
  • Loss of NO secretion is implicated in ↑ lower esophageal tone of achalasia
Motilin
  • small intestine (upper duodenum)
  • increases GI motility
  • produces migrating motor complexes (MMCs)
  • ↑ in fasting state
 -
Ghrelin 
  • P/D1 cells (stomach)
  • ↑ growth hormone, ACTH, cortisol, and prolactin secretion
  • ↑ before meals
  • ↓ after meals
  • Regulates hunger, meal initiation
  • Lost following gastric bypass surgery
  • Associated with hyperphagia in Prader-Willi
Neuropeptide-Y 
  • neurons of sympathetic nervous system
  • ↑ appetite, ↓  energy expenditure
  • Ghrelin  release
  • Leptin ↓  release
-
Glucagon-like peptide 1 (GLP-1)
  • L cells (endocrine cells of the intestinal epithelium)
  • ↑ glucose-induced insulin secretion from pancreatic β-cells
  • ↓ glucagon secretion
  • ↓ GI motility and secretions
  • Promotes satiety
  • Secreted in response to meal intake
  • Degraded by dipeptidyl peptidase IV
-
 

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Questions (6)
Lab Values
Blood, Plasma, Serum Reference Range
ALT 8-20 U/L
Amylase, serum 25-125 U/L
AST 8-20 U/L
Bilirubin, serum (adult) Total // Direct 0.1-1.0 mg/dL // 0.0-0.3 mg/dL
Calcium, serum (Ca2+) 8.4-10.2 mg/dL
Cholesterol, serum Rec: < 200 mg/dL
Cortisol, serum 0800 h: 5-23 μg/dL //1600 h:
3-15 μg/dL
2000 h: ≤ 50% of 0800 h
Creatine kinase, serum Male: 25-90 U/L
Female: 10-70 U/L
Creatinine, serum 0.6-1.2 mg/dL
Electrolytes, serum  
Sodium (Na+) 136-145 mEq/L
Chloride (Cl-) 95-105 mEq/L
Potassium (K+) 3.5-5.0 mEq/L
Bicarbonate (HCO3-) 22-28 mEq/L
Magnesium (Mg2+) 1.5-2.0 mEq/L
Estriol, total, serum (in pregnancy)  
24-28 wks // 32-36 wks 30-170 ng/mL // 60-280 ng/mL
28-32 wk // 36-40 wks 40-220 ng/mL // 80-350 ng/mL
Ferritin, serum Male: 15-200 ng/mL
Female: 12-150 ng/mL
Follicle-stimulating hormone, serum/plasma Male: 4-25 mIU/mL
Female: premenopause: 4-30 mIU/mL
midcycle peak: 10-90 mIU/mL
postmenopause: 40-250
pH 7.35-7.45
PCO2 33-45 mmHg
PO2 75-105 mmHg
Glucose, serum Fasting: 70-110 mg/dL
2-h postprandial:<120 mg/dL
Growth hormone - arginine stimulation Fasting: <5 ng/mL
Provocative stimuli: > 7ng/mL
Immunoglobulins, serum  
IgA 76-390 mg/dL
IgE 0-380 IU/mL
IgG 650-1500 mg/dL
IgM 40-345 mg/dL
Iron 50-170 μg/dL
Lactate dehydrogenase, serum 45-90 U/L
Luteinizing hormone, serum/plasma Male: 6-23 mIU/mL
Female: follicular phase: 5-30 mIU/mL
midcycle: 75-150 mIU/mL
postmenopause 30-200 mIU/mL
Osmolality, serum 275-295 mOsmol/kd H2O
Parathyroid hormone, serume, N-terminal 230-630 pg/mL
Phosphatase (alkaline), serum (p-NPP at 30° C) 20-70 U/L
Phosphorus (inorganic), serum 3.0-4.5 mg/dL
Prolactin, serum (hPRL) < 20 ng/mL
Proteins, serum  
Total (recumbent) 6.0-7.8 g/dL
Albumin 3.5-5.5 g/dL
Globulin 2.3-3.5 g/dL
Thyroid-stimulating hormone, serum or plasma .5-5.0 μU/mL
Thyroidal iodine (123I) uptake 8%-30% of administered dose/24h
Thyroxine (T4), serum 5-12 μg/dL
Triglycerides, serum 35-160 mg/dL
Triiodothyronine (T3), serum (RIA) 115-190 ng/dL
Triiodothyronine (T3) resin uptake 25%-35%
Urea nitrogen, serum 7-18 mg/dL
Uric acid, serum 3.0-8.2 mg/dL
Hematologic Reference Range
Bleeding time 2-7 minutes
Erythrocyte count Male: 4.3-5.9 million/mm3
Female: 3.5-5.5 million mm3
Erythrocyte sedimentation rate (Westergren) Male: 0-15 mm/h
Female: 0-20 mm/h
Hematocrit Male: 41%-53%
Female: 36%-46%
Hemoglobin A1c ≤ 6 %
Hemoglobin, blood Male: 13.5-17.5 g/dL
Female: 12.0-16.0 g/dL
Hemoglobin, plasma 1-4 mg/dL
Leukocyte count and differential  
Leukocyte count 4,500-11,000/mm3
Segmented neutrophils 54%-62%
Bands 3%-5%
Eosinophils 1%-3%
Basophils 0%-0.75%
Lymphocytes 25%-33%
Monocytes 3%-7%
Mean corpuscular hemoglobin 25.4-34.6 pg/cell
Mean corpuscular hemoglobin concentration 31%-36% Hb/cell
Mean corpuscular volume 80-100 μm3
Partial thromboplastin time (activated) 25-40 seconds
Platelet count 150,000-400,000/mm3
Prothrombin time 11-15 seconds
Reticulocyte count 0.5%-1.5% of red cells
Thrombin time < 2 seconds deviation from control
Volume  
Plasma Male: 25-43 mL/kg
Female: 28-45 mL/kg
Red cell Male: 20-36 mL/kg
Female: 19-31 mL/kg
Cerebrospinal Fluid Reference Range
Cell count 0-5/mm3
Chloride 118-132 mEq/L
Gamma globulin 3%-12% total proteins
Glucose 40-70 mg/dL
Pressure 70-180 mm H2O
Proteins, total < 40 mg/dL
Sweat Reference Range
Chloride 0-35 mmol/L
Urine  
Calcium 100-300 mg/24 h
Chloride Varies with intake
Creatinine clearance Male: 97-137 mL/min
Female: 88-128 mL/min
Estriol, total (in pregnancy)  
30 wks 6-18 mg/24 h
35 wks 9-28 mg/24 h
40 wks 13-42 mg/24 h
17-Hydroxycorticosteroids Male: 3.0-10.0 mg/24 h
Female: 2.0-8.0 mg/24 h
17-Ketosteroids, total Male: 8-20 mg/24 h
Female: 6-15 mg/24 h
Osmolality 50-1400 mOsmol/kg H2O
Oxalate 8-40 μg/mL
Potassium Varies with diet
Proteins, total < 150 mg/24 h
Sodium Varies with diet
Uric acid Varies with diet
Body Mass Index (BMI) Adult: 19-25 kg/m2
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