Stevens Julie E, Doran Selena, Russo Antonietta, O'Donovan Deirdre, Feinle-Bisset Christine, Rayner Christopher K, Horowitz Michael, Jones Karen L
University of Adelaide, Royal Adelaide Hospital, SA, Australia.
Am J Physiol Gastrointest Liver Physiol. 2009 Dec;297(6):G1274-80. doi: 10.1152/ajpgi.00214.2009. Epub 2009 Oct 1.
Gastric emptying (GE) of glucose is regulated closely, not only as a result of inhibitory feedback arising from the small intestine, but also because of the resulting hyperglycemia. Fructose is used widely in the diabetic diet and is known to empty from the stomach slightly faster than glucose but substantially slower than water. The aims of this study were to determine whether intravenous (iv) fructose affects GE and antropyloroduodenal motility and how any effects compare to those induced by iv glucose. Six healthy males (age: 26.7 +/- 3.8 yr) underwent concurrent measurements of GE of a solid meal (100 g ground beef labeled with 20 MBq (99m)Tc-sulfur colloid) and antropyloroduodenal motility on three separate days in randomized order during iv infusion of either fructose (0.5 g/kg), glucose (0.5 g/kg), or isotonic saline for 20 min. GE (scintigraphy), antropyloroduodenal motility (manometry), and blood glucose (glucometer) were measured for 120 min. There was a rise in blood glucose (P < 0.001) after iv glucose (peak 16.4 +/- 0.6 mmol/l) but not after fructose or saline. Intravenous glucose and fructose both slowed GE substantially (P < 0.005 for both), without any significant difference between them. Between t = 0 and 30 min, the number of antral pressure waves was less after both glucose and fructose (P < 0.002 for both) than saline, and there were more isolated pyloric pressure waves during iv glucose (P = 0.003) compared with fructose and saline (P = NS for both) infusions. In conclusion, iv fructose slows GE and modulates gastric motility in healthy subjects, and the magnitude of slowing of GE is comparable to that induced by iv glucose.
葡萄糖的胃排空（GE）受到严格调节，这不仅是小肠产生的抑制性反馈的结果，也是由此产生的高血糖的原因。果糖广泛用于糖尿病饮食，已知其从胃中排空的速度比葡萄糖略快，但比水慢得多。本研究的目的是确定静脉注射（iv）果糖是否会影响胃排空和胃幽门十二指肠运动，以及与静脉注射葡萄糖所产生的影响相比如何。六名健康男性（年龄：26.7±3.8岁）在静脉输注果糖（0.5 g/kg）、葡萄糖（0.5 g/kg）或等渗盐水20分钟期间，分三天以随机顺序同时测量固体餐（100克用20 MBq（99m）Tc-硫胶体标记的碎牛肉）的胃排空和胃幽门十二指肠运动。测量胃排空（闪烁扫描）、胃幽门十二指肠运动（测压）和血糖（血糖仪）120分钟。静脉注射葡萄糖后血糖升高（P<0.001）（峰值16.4±0.6 mmol/l），但果糖或盐水注射后未升高。静脉注射葡萄糖和果糖均显著减慢胃排空（两者均P<0.005），两者之间无显著差异。在t = 0至30分钟之间，葡萄糖和果糖注射后胃窦压力波的数量均比盐水注射后少（两者均P<0.002），与果糖和盐水注射（两者均P = NS）相比，静脉注射葡萄糖期间孤立的幽门压力波更多（P = 0.003）。总之，静脉注射果糖会减慢健康受试者的胃排空并调节胃动力，胃排空减慢的程度与静脉注射葡萄糖所诱导的程度相当。
