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Effects of acarbose on fecal nutrients, colonic pH, and short-chain fatty acids and rectal proliferative indices.
Metabolism. 1996 Sep; 45(9):1179-87.M

Abstract

Acarbose, an alpha-glycosidase inhibitor, treats diabetes mellitus by delaying the digestion and intestinal absorption of dietary carbohydrates. In effective doses, acarbose induces some passage of carbohydrates into the colon. The effect of such chronic carbohydrate transfer on colonic structure and function is unknown. We studied the effects of 1 year of acarbose administration in diabetes mellitus on fecal energy, protein, and fat, including short-chain fatty acids (SCFA) output, fecal pH, and several metabolizing bacterial species. Changes in colonic histology and epithelial cell proliferation were investigated in rectal biopsies. Fecal macronutrient output was unaffected by acarbose, but pH decreased and total SCFA, butyrate, and acetate output were markedly greater. Breath hydrogen output increased after acarbose, but digoxin-metabolizing bacteria and diacylglycerol (DAG) production were unaltered. Compared with the control, acarbose did not induce hyperplasia or change rectal proliferation. However, total fecal SCFA and butyrate output correlated inversely with proliferation in the rectal upper crypt-a biomarker of risk for colonic neoplasia. In conclusion, long-term acarbose administration does not adversely affect colonic function or fecal nutrient output. If increased fecal SCFA and butyrate reduces upper-crypt proliferation, then acarbose may reduce the risk of colonic neoplasia.

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Authors+Show Affiliations

Holt PR
Gastroenterology Division, Department of Medicine, St. Luke's- Roosevelt Hospital Center, Columbia University, New York, NY 10025, USA.
Atillasoy E
No affiliation info available
Lindenbaum J
No affiliation info available
Ho SB
No affiliation info available
Lupton JR
No affiliation info available
McMahon D
No affiliation info available
Moss SF
No affiliation info available

MeSH

AcarboseBacteriaBody WaterCell CycleCell DivisionColonDigoxinFatty Acids, VolatileFecesHumansHydrogen-Ion ConcentrationHypoglycemic AgentsPlacebosRectumTrisaccharides

Pub Type(s)

Clinical Trial
Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

8781308

Citation

Holt, P R., et al. "Effects of Acarbose On Fecal Nutrients, Colonic pH, and Short-chain Fatty Acids and Rectal Proliferative Indices." Metabolism: Clinical and Experimental, vol. 45, no. 9, 1996, pp. 1179-87.
Holt PR, Atillasoy E, Lindenbaum J, et al. Effects of acarbose on fecal nutrients, colonic pH, and short-chain fatty acids and rectal proliferative indices. Metabolism. 1996;45(9):1179-87.
Holt, P. R., Atillasoy, E., Lindenbaum, J., Ho, S. B., Lupton, J. R., McMahon, D., & Moss, S. F. (1996). Effects of acarbose on fecal nutrients, colonic pH, and short-chain fatty acids and rectal proliferative indices. Metabolism: Clinical and Experimental, 45(9), 1179-87.
Holt PR, et al. Effects of Acarbose On Fecal Nutrients, Colonic pH, and Short-chain Fatty Acids and Rectal Proliferative Indices. Metabolism. 1996;45(9):1179-87. PubMed PMID: 8781308.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effects of acarbose on fecal nutrients, colonic pH, and short-chain fatty acids and rectal proliferative indices. AU - Holt,P R, AU - Atillasoy,E, AU - Lindenbaum,J, AU - Ho,S B, AU - Lupton,J R, AU - McMahon,D, AU - Moss,S F, PY - 1996/9/1/pubmed PY - 1996/9/1/medline PY - 1996/9/1/entrez SP - 1179 EP - 87 JF - Metabolism: clinical and experimental JO - Metabolism VL - 45 IS - 9 N2 - Acarbose, an alpha-glycosidase inhibitor, treats diabetes mellitus by delaying the digestion and intestinal absorption of dietary carbohydrates. In effective doses, acarbose induces some passage of carbohydrates into the colon. The effect of such chronic carbohydrate transfer on colonic structure and function is unknown. We studied the effects of 1 year of acarbose administration in diabetes mellitus on fecal energy, protein, and fat, including short-chain fatty acids (SCFA) output, fecal pH, and several metabolizing bacterial species. Changes in colonic histology and epithelial cell proliferation were investigated in rectal biopsies. Fecal macronutrient output was unaffected by acarbose, but pH decreased and total SCFA, butyrate, and acetate output were markedly greater. Breath hydrogen output increased after acarbose, but digoxin-metabolizing bacteria and diacylglycerol (DAG) production were unaltered. Compared with the control, acarbose did not induce hyperplasia or change rectal proliferation. However, total fecal SCFA and butyrate output correlated inversely with proliferation in the rectal upper crypt-a biomarker of risk for colonic neoplasia. In conclusion, long-term acarbose administration does not adversely affect colonic function or fecal nutrient output. If increased fecal SCFA and butyrate reduces upper-crypt proliferation, then acarbose may reduce the risk of colonic neoplasia. SN - 0026-0495 UR - https://www.unboundmedicine.com/medline/citation/8781308/Effects_of_acarbose_on_fecal_nutrients_colonic_pH_and_short_chain_fatty_acids_and_rectal_proliferative_indices_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0026-0495(96)90020-7 DB - PRIME DP - Unbound Medicine ER -