体重与胃肠运动及感觉功能的关系：神经性厌食症和肥胖症的研究
Relationship of body weight with gastrointestinal motor and sensory function: studies in anorexia nervosa and obesity.
作者信息
Bluemel Sena, Menne Dieter, Milos Gabriella, Goetze Oliver, Fried Michael, Schwizer Werner, Fox Mark, Steingoetter Andreas
机构信息
Division of Gastroenterology and Hepatology, University Hospital Zurich, Raemistrasse 100, CH-8091, Zurich, Switzerland.
Menne Biomed Consulting, Tuebingen, Germany.
出版信息
BMC Gastroenterol. 2017 Jan 5;17(1):4. doi: 10.1186/s12876-016-0560-y.
BACKGROUND
Whether gastrointestinal motor and sensory function is primary cause or secondary effect of abnormal body weight is uncertain. Moreover, studies relating continuous postprandial sensations of satiation to measurable pathology are scarce. This work assessed postprandial gastrointestinal function and concurrent sensations of satiation across a wide range of body weight and after weight change.
METHODS
Patients with anorexia nervosa (AN) and obesity (OB) were investigated in reference to normal weight controls (HC). AN were additionally investigated longitudinally. Gastric emptying, antral contractions and oro-cecal transit after ingestion of a solid meal were investigated by MRI and C-lactose-ureide breath test. The dependency of self-reported sensations of satiation on the varying degree of stomach filling during gastric emptying was compared between groups.
RESULTS
24 AN (BMI 14.4 (11.9-16.0) kg/m), 16 OB (34.9 (29.6-41.5) kg/m) and 20 HC (21.9 (18.9-24.9) kg/m) were studied. Gastric half-emptying time (t) was slower in AN than HC (p = 0.016) and OB (p = 0.007), and a negative association between t and BMI was observed between BMI 12 and 25 kg/m (p = 0.007). Antral contractions and oro-cecal transit were not different. For any given gastric content volume, self-reported postprandial fullness was greater in AN than in HC or OB (p < 0.001). After weight rehabilitation, t in AN tended to become shorter (p = 0.09) and postprandial fullness was less marked (p < 0.01).
CONCLUSIONS
A relationship between body weight and gastric emptying as well as self-reported feelings of satiation is present. AN have slower gastric emptying and heightened visceral perception compared to HC and OB. Longitudinal follow-up after weight rehabilitation in AN suggests these abnormalities are not a primary feature, but secondary to other factors that determine abnormal body weight.
TRIAL REGISTRATION
Registered July 20, 2009 at ClinicalTrials.gov ( NCT00946816 ).
背景
胃肠道运动和感觉功能是体重异常的主要原因还是次要结果尚不确定。此外，将餐后持续饱腹感与可测量的病理情况相关联的研究很少。这项研究评估了不同体重范围以及体重变化后餐后的胃肠功能和同时出现的饱腹感。
方法
以正常体重对照组（HC）为参照，对神经性厌食症（AN）患者和肥胖症（OB）患者进行研究。对神经性厌食症患者还进行了纵向研究。通过磁共振成像（MRI）和C-乳糖脲呼气试验，研究了摄入固体食物后的胃排空、胃窦收缩和口盲肠转运情况。比较了各组之间自我报告的饱腹感对胃排空期间不同程度胃充盈的依赖性。
结果
研究了24例神经性厌食症患者（体重指数[BMI]为14.4[11.9 - 16.0]kg/m²）、16例肥胖症患者（BMI为34.9[29.6 - 41.5]kg/m²）和20例正常体重对照组（BMI为21.9[18.9 - 24.9]kg/m²）。神经性厌食症患者的胃半排空时间（t）比正常体重对照组（p = 0.016）和肥胖症患者（p = 0.007）慢，并且在BMI为12至25 kg/m²之间观察到t与BMI呈负相关（p = 0.007）。胃窦收缩和口盲肠转运没有差异。对于任何给定的胃内容物体积，神经性厌食症患者自我报告的餐后饱腹感比正常体重对照组或肥胖症患者更强（p < 0.001）。体重恢复后，神经性厌食症患者的t趋于缩短（p = 0.09），餐后饱腹感也不那么明显（p < 0.01）。
结论
体重与胃排空以及自我报告的饱腹感之间存在关联。与正常体重对照组和肥胖症患者相比，神经性厌食症患者的胃排空较慢且内脏感觉增强。神经性厌食症患者体重恢复后的纵向随访表明，这些异常不是主要特征，而是由其他决定体重异常的因素导致的次要结果。
试验注册
于2009年7月20日在ClinicalTrials.gov注册（NCT00946816）。
Zotero 插件