Clinic of Endocrinology, Diabetes and Metabolism University Hospital Basel, Basel, Switzerland; Department of Biomedicine, University of Basel, Basel, Switzerland; Dresden International University, Division of Health Care Sciences Center for Clinical Research and Management Education Dresden, Germany.
Clinic of Endocrinology, Diabetes and Metabolism University Hospital Basel, Basel, Switzerland; Department of Biomedicine, University of Basel, Basel, Switzerland.
Appetite. 2020 Dec 1;155:104792. doi: 10.1016/j.appet.2020.104792. Epub 2020 Jul 21.
The initial release of insulin in response to food stimuli acting on receptors in the head and oropharynx is called the cephalic phase of insulin secretion. Insulin has been shown to act centrally to regulate food intake and glucose metabolism and the cephalic phase of insulin secretion may contribute to these functions. Though well documented in laboratory animals, the existence of cephalic phase insulin release in humans has recently come into question. We therefore performed a systematic review and meta-analysis of studies of cephalic phase insulin release in humans. Efficacy outcomes included any change in circulating insulin levels in healthy human volunteers post any food stimulus as compared to baseline or control in a time period of no longer than 10 min. Primary outcome: The overall pooled effect size estimate for cephalic phase insulin release was 0.47 [0.36, 0.58] p-value <0.0001. Secondary outcomes: A random effects meta-analysis with an added moderator for type of stimulus presentation (one, two, four or five sensory qualities) and type of stimulus offered (liquid, solid formulation) also significantly influenced results p = 0.0116 and p = 0.0024 respectively, while sex had no significant effect. Sensitivity Analysis: More restrictive analyses only including studies that used non-ingestive stimuli (p = 0.0001), or studies that reported insulin values within 5 min post stimulus presentation (p < 0.0001) still showed significant positive overall effect size estimates. In summary, our analysis shows that there is evidence for the presence of cephalic phase insulin secretion in humans. Secondary analyses suggest that the type and presentation of stimulus may significantly influence cephalic phase insulin secretion, while sex had no significant effect on cephalic phase insulin secretion.
进食刺激物作用于头部和口咽部受体引起的胰岛素初始释放称为胰岛素分泌的头期。胰岛素已被证明具有中枢作用，可调节食物摄入和葡萄糖代谢，而胰岛素的头期分泌可能有助于这些功能。尽管在实验室动物中得到了很好的证明，但最近人们对人类是否存在头期胰岛素释放产生了质疑。因此，我们对人类头期胰岛素释放的研究进行了系统评价和荟萃分析。疗效结果包括与基线或对照相比，任何食物刺激后健康人类志愿者循环胰岛素水平的任何变化，时间不超过 10 分钟。主要结果：头期胰岛素释放的总体汇总效应大小估计值为 0.47 [0.36, 0.58] p 值 <0.0001。次要结果：随机效应荟萃分析，添加了刺激呈现方式（一种、两种、四种或五种感觉质量）和刺激提供方式（液体、固体配方）的调节变量，也显著影响了结果 p 值分别为 0.0116 和 0.0024，而性别没有显著影响。敏感性分析：仅包括使用非摄入性刺激的研究（p = 0.0001）或报告刺激后 5 分钟内胰岛素值的研究（p < 0.0001）的更严格分析仍然显示出显著的阳性总体效应大小估计值。总之，我们的分析表明，有证据表明人类存在头期胰岛素分泌。二次分析表明，刺激的类型和呈现方式可能会显著影响头期胰岛素分泌，而性别对头期胰岛素分泌没有显著影响。
