Division of Surgery, Department of Clinical Sciences, Danderyd Hospital, Karolinska Institute, SE-182 88 Stockholm, Sweden.
Neurogastroenterol Motil. 2010 Jun;22(6):e192-200. doi: 10.1111/j.1365-2982.2009.01463.x. Epub 2010 Jan 21.
Ghrelin is produced by enteroendocrine cells in the gastric mucosa and stimulates gastric emptying in healthy volunteers and patients with gastroparesis in short-term studies. The aim of this study was to evaluate effects of intravenous ghrelin on gastrointestinal motility and glucose homeostasis during a 6-h infusion in humans.
Ghrelin (15 pmol kg(-1) min(-1)) or saline was infused intravenously for 360 min after intake of radio-opaque markers, acetaminophen, and lactulose after a standardized breakfast in 12 male volunteers. Gastric emptying, orocecal transit, colonic transit, postprandial plasma concentrations of glucose, insulin, glucagon-like peptide-1 (GLP-1), and peptide YY were assessed. In vitro studies of gastrointestinal muscle contractility were performed.
The gastric emptying rate was faster for ghrelin compared to saline (P = 0.002) with a shorter half-emptying time (50.3 +/- 3.9 vs 59.9 +/- 4.4 min, P = 0.004). There was no effect of ghrelin on orocecal or colonic transit. Postprandial elevations of plasma glucose, insulin, and GLP-1 occurred 15 min earlier and were higher with ghrelin. The insulinogenic index did not change during ghrelin infusion. Basal in vitro contractility was unaffected by ghrelin.
CONCLUSIONS & INFERENCES: The effect of a 6-h ghrelin infusion on gastrointestinal motility is limited to the stomach without affecting orocecal or colonic transit. Plasma glucose, insulin, and GLP-1 are elevated postprandially, probably as a result of the hastened gastric emptying. Changes in glucose homeostasis as a consequence of stimulated gastric emptying and hormone release, need to be taken into account in the use of pharmacological stimulants for the treatment of motility disorders.
胃饥饿素由胃黏膜的肠内分泌细胞产生，在短期研究中可刺激健康志愿者和胃轻瘫患者的胃排空。本研究旨在评估静脉内给予胃饥饿素对人体 6 小时输注期间胃肠动力和葡萄糖稳态的影响。
12 名男性志愿者在标准化早餐后，经口摄入不透射线标志物、对乙酰氨基酚和乳果糖，然后静脉输注胃饥饿素（15 pmol/kg/min）或生理盐水 360 分钟。评估胃排空、口腔-盲肠传输、结肠传输、餐后血浆葡萄糖、胰岛素、胰高血糖素样肽-1（GLP-1）和肽 YY 浓度。进行胃肠肌肉收缩的体外研究。
与生理盐水相比，胃饥饿素使胃排空更快（P=0.002），胃排空半排空时间更短（50.3±3.9 分钟 vs 59.9±4.4 分钟，P=0.004）。胃饥饿素对口腔-盲肠或结肠传输无影响。餐后血浆葡萄糖、胰岛素和 GLP-1 升高提前 15 分钟出现，且升高幅度更大。胃饥饿素输注期间胰岛素原指数没有变化。基础体外收缩性不受胃饥饿素影响。
6 小时胃饥饿素输注对胃肠动力的影响仅限于胃，而不影响口腔-盲肠或结肠传输。餐后血糖、胰岛素和 GLP-1 升高，可能是由于胃排空加快所致。由于胃排空和激素释放的刺激而导致的葡萄糖稳态变化，在使用药物刺激剂治疗运动障碍时需要加以考虑。
