{
  "abstract": "Introduction Once weekly GLP-1 receptor analogues (GLP-1 RAs) are now established for diabetes and weight management, with their usage increasing worldwide. Frequent gastrointestinal side effects occur including nausea, vomiting and delayed gastric emptying.Enteroendocrine cells are found throughout the gut, with the expression of gut hormones changing moving along the gut. Gastric inhibitory peptide (GIP) is expressed proximally whilst hormones glucagon like-peptide 1 (GLP-1) and peptide YY (PYY) expressed more distally.This study aimed to explore how enteroendocrine hormones levels alter on initiation of GLP-1 RA therapy for weight management.Methods Eleven participants from weight management clinic were recruited to undergo a two-visit study with blood sampling. The first visit took place before starting GLP-1 RA and follow up visit after 6-8 weeks of GLP-1 RA.Nine participants were initiated on semaglutide (n=8 0.5mg once weekly at follow up, n=1 0.25 mg) whilst 2 participants with a background of type 2 diabetes were initiated on tirzepatide (n=2, 5mg once weekly at follow up).Visits included a prolonged fasting hormone profile (15-minute sampling over 3 hours), and a 2-hour post prandial profile involving a liquid mixed meal.Three of the 11 participants had a background diagnosis of bile acid diarrhoea (BAD). One BAD participant returned for a 3rd meal study on 10mg tirzepatide.Blood samples were analysed with immunoassay and mass spectrometry, with measurements obtained for PYY, GLP-1, cholecystokinin (CCK) and GIP.Results Post GLP-1 RA there were trending increases in post prandial responses of proximally expressed GIP, and trending decreases in post prandial responses of distally expressed GLP-1 and PYY.2 of the 3 participants with BAD, had symptom remission and were able to wean off bile acid sequestrant treatment. The participant attending 3 visits (baseline, 5mg and 10mg once weekly tirzepatide), displayed dose dependent increases in post prandial GIP, and decreases in PYY and CCK.Discussion The pattern of change in post prandial hormone profiles of increased levels of proximally expressed hormones and decreased levels of distally expressed hormones is consistent with a profile of delayed gastric emptying. Further work is needed to establish if changes in gut hormone profiles show relations to gastrointestinal symptom onset and treatment response. Further exploration of translational use of GLP-1 RA to treat symptoms of diarrhoea in BAD is merited.Abstract FP56 Figure 1",
  "authors": [
    {
      "affiliations": [
        "Institute of Metabolic Science, University of Cambridge, Cambridge, United Kingdom"
      ],
      "name": "Christopher Bannon"
    },
    {
      "affiliations": [
        "Institute of Metabolic Science, University of Cambridge, Cambridge, United Kingdom"
      ],
      "name": "Sofia Aliotta"
    },
    {
      "affiliations": [
        "Institute of Metabolic Science, University of Cambridge, Cambridge, United Kingdom"
      ],
      "name": "Htar Htar Hlaing"
    },
    {
      "affiliations": [
        "Institute of Metabolic Science, University of Cambridge, Cambridge, United Kingdom"
      ],
      "name": "Austin Punnoose"
    },
    {
      "affiliations": [
        "Institute of Metabolic Science, University of Cambridge, Cambridge, United Kingdom"
      ],
      "name": "Agatha van der Klaauw"
    },
    {
      "affiliations": [
        "Division of Digestive Diseases, Imperial College London, London, United Kingdom"
      ],
      "name": "Julian Walters"
    },
    {
      "affiliations": [
        "Institute of Metabolic Science, University of Cambridge, Cambridge, United Kingdom"
      ],
      "name": "Richard Kay"
    },
    {
      "affiliations": [
        "Institute of Metabolic Science, University of Cambridge, Cambridge, United Kingdom"
      ],
      "name": "Frank Reimann"
    },
    {
      "affiliations": [
        "Institute of Metabolic Science, University of Cambridge, Cambridge, United Kingdom"
      ],
      "name": "Fiona Gribble"
    }
  ],
  "title": "FP56 Semaglutide and tirzepatide affect post prandial gut hormone responses and induce symptom remission in two patients with bile acid diarrhoea",
  "uid": "74324c01-3e4d-5ecd-9640-7bdced278606"
}