Evaluation of gastrin secretion in diabetic subjects with normal or abnormal cardiovascular autonomic function tests.

The serum gastrin response to a meat extract drink was measured in 16 non-diabetic subjects, in 40 diabetic subjects and 9 patients with positive tests for gastric parietal cell antibodies. Standard cardiovascular autonomic function tests were also performed in diabetic subjects. The test drink produced a highly significant rise in the serum gastrin concentration (p less than 0.001). Diabetic subjects with normal cardiovascular autonomic function tests had slightly lower stimulated gastrin concentrations than non-diabetic subjects. In diabetic subjects with abnormal cardiovascular autonomic function tests the distribution of gastrin concentrations after the test drink was bimodal. Eleven out of 20 had 45-min gastrin concentrations greater than 120 pg/ml, compared with 2 out of 20 diabetics with normal cardiovascular autonomic function tests and 1 out of 16 non-diabetic subjects (p less than 0.001). Much higher gastrin responses were found in 5 out of 9 patients with positive tests for gastric parietal cell antibodies. An increased gastrin response may be found in patients with abnormal autonomic function but its value as a marker is limited by the small amplitude of the change and by the significant prevalence of atrophic gastritis, in which much higher gastrin responses may be found.