National Health and Medical Research Council (NHMRC) Centre of Research Excellence in Translating Nutritional Science to Good Health.
School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, South Australia, Australia.
Am J Clin Nutr. 2018 Jul 1;108(1):156-162. doi: 10.1093/ajcn/nqy060.
Postprandial hypotension (PPH) occurs frequently, particularly in older people and those with type 2 diabetes, and is associated with increased morbidity and mortality. The magnitude of the decrease in blood pressure (BP) induced by carbohydrate, fat, and protein appears to be comparable and results from the interaction of macronutrients with the small intestine, including an observed stimulation of mesenteric blood flow. It is not known whether artificial sweeteners, such as sucralose, which are widely used, affect BP.
The aim of this study was to evaluate the effects of intraduodenal sucralose on BP and superior mesenteric artery (SMA) blood flow, compared with intraduodenal glucose and saline (control), in healthy older subjects.
Twelve healthy subjects (6 men, 6 women; aged 66-79 y) were studied on 3 separate occasions in a randomized, double-blind, crossover design. After an overnight fast, subjects had concurrent measurements of BP and heart rate (HR; automated device), SMA blood flow (Doppler ultrasound), and blood glucose (glucometer) during intraduodenal infusion of 1) glucose (25% wt:vol, ∼1400 mOsmol/L), 2) sucralose (4 mmol/L, ∼300 mOsmol/L), or 3) saline (0.9% wt:vol, ∼300 mOsmol/L) at a rate of 3 mL/min for 60 min followed by intraduodenal saline for a further 60 min.
There was a decrease in mean arterial BP (P < 0.001) during intraduodenal glucose [baseline (mean ± SEM): 91.7 ± 2.6 mm Hg compared with t = 60 min: 85.9 ± 2.8 mm Hg] but not during intraduodenal saline or intraduodenal sucralose. The HR (P < 0.0001) and SMA blood flow (P < 0.0001) also increased during intraduodenal glucose but not during intraduodenal saline or intraduodenal sucralose. As expected, blood glucose concentrations increased in response to glucose (P < 0.0001) but not saline or sucralose.
In healthy older subjects, intraduodenal administration of the artificial sweetener sucralose was not associated with changes in BP or SMA blood flow. Further studies are therefore warranted to determine the potential role for artificial sweeteners as a therapy for PPH. This trial was registered at http://www.ANZCTR.org.au as ACTRN12617001249347.
餐后低血压（PPH）很常见，尤其是在老年人和 2 型糖尿病患者中，与发病率和死亡率的增加有关。碳水化合物、脂肪和蛋白质引起的血压（BP）下降幅度似乎相当，这是由于宏量营养素与小肠相互作用的结果，包括观察到的肠系膜血流刺激。目前尚不清楚广泛使用的人工甜味剂，如三氯蔗糖，是否会影响 BP。
本研究旨在评估十二指肠内给予三氯蔗糖对健康老年人血压（BP）和肠系膜上动脉（SMA）血流的影响，并与十二指肠内给予葡萄糖和生理盐水（对照）进行比较。
12 名健康受试者（6 名男性，6 名女性；年龄 66-79 岁）以随机、双盲、交叉设计在 3 次不同时间点进行研究。受试者禁食过夜后，在以 3 毫升/分钟的速度进行 60 分钟的十二指肠内输注 1）葡萄糖（25%wt:vol，约 1400 mOsmol/L）、2）三氯蔗糖（4mmol/L，约 300 mOsmol/L）或 3）生理盐水（0.9%wt:vol，约 300 mOsmol/L）期间，使用自动装置同时测量血压和心率（HR）、多普勒超声测量 SMA 血流、血糖仪测量血糖（glucometer）。60 分钟后，再给予十二指肠内生理盐水 60 分钟。
与基线（平均 ± SEM：91.7 ± 2.6mmHg）相比，十二指肠内给予葡萄糖时平均动脉压（MAP）（P < 0.001）下降[t = 60 分钟：85.9 ± 2.8mmHg]，但十二指肠内给予生理盐水或三氯蔗糖时 MAP 没有下降。HR（P < 0.0001）和 SMA 血流（P < 0.0001）也在十二指肠内给予葡萄糖时增加，但在给予生理盐水或三氯蔗糖时没有增加。如预期的那样，血糖浓度在葡萄糖（P < 0.0001）但不是生理盐水或三氯蔗糖的反应中增加。
在健康老年人中，十二指肠内给予人工甜味剂三氯蔗糖与血压或 SMA 血流变化无关。因此，需要进一步研究以确定人工甜味剂作为 PPH 治疗的潜在作用。该试验在 http://www.ANZCTR.org.au 注册，注册号为 ACTRN12617001249347。
