Translational Research Centre for Gastrointestinal Disorders, University of Leuven, Leuven, Belgium.
Gut. 2016 Feb;65(2):214-24. doi: 10.1136/gutjnl-2014-308472. Epub 2014 Dec 24.
Hunger is controlled by the brain, which receives input from signals of the GI tract (GIT). During fasting, GIT displays a cyclical motor pattern, the migrating motor complex (MMC), regulated by motilin.
To study the relationship between hunger and MMC phases (I-III), focusing on spontaneous and pharmacologically induced phase III and the correlation with plasma motilin and ghrelin levels. The role of phase III was also studied in the return of hunger after a meal in healthy individuals and in patients with loss of appetite.
In fasting healthy volunteers, mean hunger ratings during a gastric (62.5±7.5) but not a duodenal (40.4±5.4) phase III were higher (p<0.0005) than during phase I (27.4±4.7) and phase II (37±4.5). The motilin agonist erythromycin, but not the cholinesterase inhibitor neostigmine, induced a premature gastric phase III, which coincided with an increase in hunger scores from 29.2±7 to 61.7±8. The somatostatin analogue octreotide induced a premature intestinal phase III without a rise in hunger scores. Hunger ratings significantly correlated (β=0.05; p=0.01) with motilin plasma levels, and this relationship was lost after erythromycin administration. Motilin, but not ghrelin administration, induced a premature gastric phase III and a rise in hunger scores. In contrast to octreotide, postprandial administration of erythromycin induced a premature gastric phase III accompanied by an early rise in hunger ratings. In patients with unexplained loss of appetite, gastric phase III was absent and hunger ratings were lower.
Motilin-induced gastric phase III is a hunger signal from GIT in man.
饥饿受大脑控制，大脑接收来自胃肠道（GI）信号的输入。在禁食期间，GI 显示周期性运动模式，即移行性运动复合波（MMC），受胃动素调节。
研究饥饿与 MMC 相（I-III）之间的关系，重点关注自发性和药物诱导的 III 相以及与血浆胃动素和 ghrelin 水平的相关性。还研究了 III 相在健康个体餐后食欲恢复和食欲减退患者中的作用。
在禁食的健康志愿者中，胃期（62.5±7.5）而不是十二指肠期（40.4±5.4）的平均饥饿评分（62.5±7.5）高于 I 相（27.4±4.7）和 II 相（37±4.5）（p<0.0005）。胃动素激动剂红霉素，但不是胆碱酯酶抑制剂新斯的明，可诱导胃过早 III 期，同时饥饿评分从 29.2±7 增加到 61.7±8。生长抑素类似物奥曲肽可诱导过早的肠期 III 期，而饥饿评分无升高。饥饿评分与血浆胃动素水平显著相关（β=0.05；p=0.01），而这种关系在红霉素给药后消失。胃动素而不是 ghrelin 给药可诱导胃过早 III 期和饥饿评分升高。与奥曲肽相反，红霉素餐后给药可诱导胃过早 III 期，并伴有饥饿评分的早期升高。在不明原因的食欲减退患者中，胃期 III 期缺失，饥饿评分降低。
在人类中，胃动素诱导的胃期 III 期是来自 GI 的饥饿信号。
