Rayner C K, Park H S, Doran S M, Chapman I M, Horowitz M
University of Adelaide Department of Medicine, Royal Adelaide Hospital, Adelaide, South Australia 5000, Australia.
Am J Physiol Gastrointest Liver Physiol. 2000 Jan;278(1):G98-G104. doi: 10.1152/ajpgi.2000.278.1.G98.
Recent studies suggest that the interaction between small intestinal nutrient stimulation and the blood glucose concentration is important in the regulation of gastric motility and appetite. The purpose of this study was to determine whether the effects of cholecystokinin octapeptide (CCK-8) on antropyloric motility and appetite are influenced by changes in the blood glucose concentration within the normal postprandial range. Seven healthy volunteers were studied on 4 separate days. A catheter incorporating a sleeve sensor was positioned across the pylorus, and the blood glucose was stabilized at either 4 mmol/l (2 days) or 8 mmol/l (2 days). After the desired blood glucose had been maintained for 90 min, an intravenous infusion of either CCK-8 (2 ng. kg(-1). min(-1)) or saline (control) was given for 60 min. Thirty minutes after the infusion began, the catheter was removed and subjects drank 400 ml of water with guar gum before being offered a buffet meal. The amount of food consumed (kcal) was quantified. The order of the studies was randomized and single-blinded. There were fewer antral waves at a blood glucose of 8 than at 4 mmol/l during the 90-min period before the infusions (P<0.05) and during the first 30 min of CCK-8 or saline infusion (P = 0.07). CCK-8 suppressed antral waves (P<0.05), stimulated isolated pyloric pressure waves (IPPWs) (P<0.01), and increased basal pyloric pressure (P<0.005) compared with control. During administration of CCK-8, basal pyloric pressure (P<0.01), but not the number of IPPWs, was greater at a blood glucose of 8 mmol/l than at 4 mmol/l. CCK-8 suppressed the energy intake at the buffet meal (P<0.01), with no significant difference between the two blood glucose concentrations. We conclude that the acute effect of exogenous CCK-8 on basal pyloric pressure, but not appetite, is modulated by physiological changes in the blood glucose concentration.
近期研究表明，小肠营养刺激与血糖浓度之间的相互作用在胃动力和食欲调节中具有重要意义。本研究的目的是确定在正常餐后范围内血糖浓度的变化是否会影响八肽胆囊收缩素（CCK-8）对胃窦幽门动力和食欲的作用。7名健康志愿者在4个不同日期接受研究。将一根装有套管传感器的导管置于幽门处，血糖稳定在4 mmol/l（2天）或8 mmol/l（2天）。在达到所需血糖水平并维持90分钟后，静脉输注CCK-8（2 ng·kg⁻¹·min⁻¹）或生理盐水（对照）60分钟。输注开始30分钟后，取出导管，受试者在享用自助餐前饮用400 ml含瓜尔胶的水。对摄入的食物量（千卡）进行量化。研究顺序随机且单盲。在输注前的90分钟内（P<0.05）以及CCK-8或生理盐水输注的前30分钟内（P = 0.07），血糖为8 mmol/l时的胃窦波比4 mmol/l时少。与对照组相比，CCK-8抑制胃窦波（P<0.05），刺激孤立幽门压力波（IPPWs）（P<0.01），并增加基础幽门压力（P<0.005）。在CCK-8给药期间，血糖为8 mmol/l时的基础幽门压力（P<0.01）高于4 mmol/l时，但IPPWs的数量无差异。CCK-8抑制自助餐时的能量摄入（P<0.01），两种血糖浓度之间无显著差异。我们得出结论，外源性CCK-8对基础幽门压力的急性作用而非对食欲的作用，会受到血糖浓度生理变化的调节。
