McLaughlin J T, Troncon L E, Barlow J, Heggie L J, Thompson D G
University of Manchester, Department of Medicine, Hope Hospital, Salford, UK.
Gut. 1998 Aug;43(2):248-51. doi: 10.1136/gut.43.2.248.
BACKGROUND/AIM: The presence of lipid in the upper gut is able to modify gastrointestinal motor performance, but its influence on the relaxation of the human stomach, which is known to modify gastric emptying, remains incompletely understood. The relaxation of the proximal stomach in response to various lipid concentrations was therefore studied in healthy volunteers. Since the observed effects could be mediated through osmolality or energy sensitive pathways, the effects of equicaloric and equiosmolar non-lipid solutions were also determined.
The tone of the proximal stomach was measured during stepwise inflation of a non-compliant bag sited in the proximal stomach, both before and after a test meal was delivered intragastrically. Iso-osmolar lipid emulsions were diluted in iso-osmolar saline at concentrations of 1.25, 2.5, 5, 10, and 20%. NaCl solutions at osmolalities of 300, 600, 1200 and 2400 mmol/kg and glucose solutions of 836 and 3344 kJ/l were also given.
All lipid meals of 2.5% or greater concentration induced a reduction in gastric tone in a non-dose-dependent manner, responses to 5% lipid (median (range) 74 (62-92)%) being similar to those to 20% lipid (80 (55-83)%; p > 0.05). No relaxation was elicited by isocaloric glucose. NaCl only consistently caused relaxation at 2400 mmol/kg.
Lipid meals reduce human proximal gastric tone by a lipid specific mechanism, independently of their energy content or osmolality.
背景/目的：上消化道中脂质的存在能够改变胃肠运动功能，但其对人胃松弛（已知可改变胃排空）的影响仍未完全明确。因此，我们在健康志愿者中研究了近端胃对不同脂质浓度的松弛反应。由于观察到的效应可能通过渗透压或能量敏感途径介导，所以我们也测定了等热量和等渗非脂质溶液的效应。
在将一个置于近端胃的非顺应性气囊逐步充气的过程中，测量近端胃的张力，测量在胃内给予试验餐前后各进行一次。将等渗脂质乳剂用等渗盐水稀释，浓度分别为1.25%、2.5%、5%、10%和20%。还给予了渗透压分别为300、600、1200和2400 mmol/kg的NaCl溶液以及能量分别为836和3344 kJ/l的葡萄糖溶液。
所有浓度为2.5%及以上的脂质餐均以非剂量依赖性方式引起胃张力降低，对5%脂质的反应（中位数（范围）74（62 - 92）%）与对20%脂质的反应（80（55 - 83）%；p > 0.05）相似。等热量葡萄糖未引起松弛。NaCl仅在2400 mmol/kg时持续引起松弛。
脂质餐通过脂质特异性机制降低人近端胃张力，与其能量含量或渗透压无关。
