Vazquez Roque Maria I, Camilleri Michael, Stephens Debra A, Jensen Michael D, Burton Duane D, Baxter Kari L, Zinsmeister Alan R
Clinical Enteric Neuroscience Translational and Epidemiological Research Program, Mayo Clinic College of Medicine, Rochester, Minnesota 55905, USA.
Gastroenterology. 2006 Dec;131(6):1717-24. doi: 10.1053/j.gastro.2006.10.025. Epub 2006 Oct 15.
BACKGROUND & AIMS: Peptide YY (PYY) levels are reported to be decreased in obesity. The relation between gastric functions, satiation, and gut hormones in obesity is incompletely understood. The aim of this study was to compare gastric volumes, emptying, maximum tolerated volumes, postchallenge symptoms, and selected gut hormones in normal, overweight, or obese healthy volunteers.
In 73 nonbulimic normal, overweight, or obese participants weighing less than 137 kg, we measured gastric emptying of solids and liquids by scintigraphy (gastric emptying half-time [GE t(1/2)]); gastric volumes by single-photon emission computed tomography; maximum tolerated volumes and symptoms by satiation test; and plasma leptin, ghrelin, insulin, glucagon-like peptide 1, and PYY levels. Groups were compared using 1-way analysis of covariance adjusted for sex. Univariate associations among measured responses were assessed using Spearman correlations. Multiple linear regression models, adjusting for weight and sex, assessed the independent ability of gastric functions and hormones to predict satiation volume.
Obese and overweight subjects had significantly lower postprandial gastric volumes, higher fasting and postprandial insulin and leptin levels, and lower fasting ghrelin and lower postprandial reduction in ghrelin levels. PYY levels were not different in obese or overweight subjects compared with controls. The GE t(1/2) was correlated inversely with postprandial PYY; increased body weight was associated with faster GE t(1/2) of solids (r(s) = 0.33, P = .005) and liquids (r(s) = 0.24, P = .04). Postprandial changes in gastric volume and PYY were independent predictors of satiation (both P = .01).
Overweight or obesity are associated with lower postprandial gastric volumes and normal PYY levels. Gastric emptying influences postprandial PYY levels. Postprandial PYY and gastric volume independently predict satiation volume in nonbulimic people across a wide body mass index range.
据报道，肥胖者体内的肽YY（PYY）水平会降低。肥胖状态下胃功能、饱腹感与肠道激素之间的关系尚未完全明确。本研究旨在比较正常、超重或肥胖的健康志愿者的胃容积、排空情况、最大耐受量、激发试验后症状以及特定肠道激素水平。
在73名体重小于137kg、非贪食症的正常、超重或肥胖参与者中，我们通过闪烁扫描法测量固体和液体的胃排空情况（胃排空半衰期[GE t(1/2)]）；通过单光子发射计算机断层扫描测量胃容积；通过饱腹感测试测量最大耐受量和症状；并检测血浆瘦素、胃饥饿素、胰岛素、胰高血糖素样肽1和PYY水平。使用经性别调整的单因素协方差分析对各组进行比较。使用Spearman相关性评估测量反应之间的单变量关联。在调整体重和性别后，多元线性回归模型评估胃功能和激素预测饱腹感容积的独立能力。
肥胖和超重受试者的餐后胃容积显著较低，空腹和餐后胰岛素及瘦素水平较高，空腹胃饥饿素较低且餐后胃饥饿素水平下降幅度较小。与对照组相比，肥胖或超重受试者的PYY水平无差异。GE t(1/2)与餐后PYY呈负相关；体重增加与固体（r(s)=0.33，P=0.005）和液体（r(s)=0.24，P=0.04）的GE t(1/2)加快有关。餐后胃容积和PYY的变化是饱腹感的独立预测因素（均P=0.01）。
超重或肥胖与餐后胃容积降低和正常PYY水平相关。胃排空会影响餐后PYY水平。在广泛的体重指数范围内，餐后PYY和胃容积可独立预测非贪食症患者的饱腹感容积。
