Steingoetter Andreas, Buetikofer Simon, Curcic Jelena, Menne Dieter, Rehfeld Jens F, Fried Michael, Schwizer Werner, Wooster Tim J
Division of Gastroenterology and Hepatology, University Hospital Zurich, Zurich, Switzerland;
Institute for Biomedical Engineering, University of Zurich and ETH Zurich, Zurich, Switzerland.
J Nutr. 2017 Apr;147(4):706-714. doi: 10.3945/jn.116.237800. Epub 2017 Feb 22.
Limited information exists on the relation between fat emulsion structure and its effect on the release of gastrointestinal hormones and feelings of satiation. We investigated the impact of fat emulsion droplet size, gravitational and acid stability, and redispersibility on gastrointestinal responses and sought to deduce the relative importance of the hormones ghrelin, cholecystokinin, glucagon-like peptide-1, and peptide YY (PYY) in controlling fat emptying and related satiation. Within a randomized, double-blind, 4-armed crossover study, an extensive data set was generated by MRI of gastric function, analysis of hormone profiles, and ratings of satiation in healthy participants [10 women and 7 men with a mean ± SD age of 25 ± 7 y and body mass index (in kg/m) of 22 ± 1] after intake of 4 different fat emulsions. Iterative Bayesian model averaging variable selection was used to investigate the influence of hormone profiles in controlling fat emulsion emptying and satiation. The emulsion structure had a distinct effect on the gastric emptying (primary outcome), gastrointestinal hormone profiles, and ratings of satiation (secondary outcomes). Gravitational and acid stability were stronger modulators of fat emptying and hormone profiles than were emulsion droplet size or redispersibility. Cholecystokinin and PYY were most strongly affected by fat emulsion instability and droplet size. Although both hormones were relevant predictors of gastric emptying, only PYY was identified as a relevant predictor of satiation. This work indicates that evenly dispersed, stable, small-emulsion droplets within the stomach lead to prolonged gastric distension, longer ghrelin suppression, and accelerated fat sensing (cholecystokinin and PPY), triggering prolonged feelings of satiation. It suggests that the effects of emulsion instability and droplet size on energy consumption are best studied by assessing changes in gastric emptying and ratings of satiation rather than changes in venous hormone profiles. This trial was registered at clinicaltrials.gov as NCT01253005.
关于脂肪乳剂结构与其对胃肠激素释放及饱腹感影响之间的关系，现有信息有限。我们研究了脂肪乳剂滴径、重力和酸稳定性以及再分散性对胃肠反应的影响，并试图推断胃饥饿素、胆囊收缩素、胰高血糖素样肽 -1 和肽 YY（PYY）在控制脂肪排空及相关饱腹感方面的相对重要性。在一项随机、双盲、四臂交叉研究中，通过对健康参与者（10 名女性和 7 名男性，平均年龄±标准差为 25±7 岁，体重指数[kg/m²]为 22±1）摄入 4 种不同脂肪乳剂后的胃功能进行 MRI 检查、分析激素谱以及进行饱腹感评分，生成了一个广泛的数据集。采用迭代贝叶斯模型平均变量选择法来研究激素谱在控制脂肪乳剂排空和饱腹感方面的影响。乳剂结构对胃排空（主要结果）、胃肠激素谱和饱腹感评分（次要结果）有显著影响。重力和酸稳定性对脂肪排空和激素谱的调节作用比乳剂滴径或再分散性更强。胆囊收缩素和 PYY 受脂肪乳剂不稳定性和滴径的影响最大。尽管这两种激素都是胃排空的相关预测指标，但只有 PYY 被确定为饱腹感的相关预测指标。这项研究表明，胃内均匀分散、稳定的小乳剂滴会导致胃扩张时间延长、胃饥饿素抑制时间延长以及脂肪感知加速（胆囊收缩素和 PPY），从而引发持久的饱腹感。这表明，通过评估胃排空变化和饱腹感评分而非静脉激素谱变化，能更好地研究乳剂不稳定性和滴径对能量消耗的影响。该试验已在 clinicaltrials.gov 上注册，注册号为 NCT01253005。
