Clinical Medical College, Yangzhou University, Yangzhou, China.
Department of Pharmaceutics, University of Florida, Gainesville, Florida; Department of Biostatistics, University of Florida, Gainesville, Florida.
Clin Ther. 2021 Oct;43(10):1768-1788. doi: 10.1016/j.clinthera.2021.08.006. Epub 2021 Sep 3.
Gastric emptying time is one of limiting factors that determines the pharmacokinetic properties of drugs administered by mouth. Despite the high prevalence of obesity worldwide, modifications in gastric emptying time have not been systematically addressed in this set of patients. The current analysis aims to quantitatively address obesity-related changes in gastric emptying time of solids, semisolids, and liquids compared with lean individuals, highlighting the relevant pharmacokinetic implications of oral drug absorption in patients with obesity.
We searched the Cochrane Library, PubMed, Web of Science, and Embase for all relevant articles published until November 1, 2020. Differences in gastrointestinal variables in relation to gastric emptying between obese and lean individuals were quantified by weighted mean difference (WMD) and ratio of means (RoM). Robustness of the analyses was evaluated by subgroup analysis and publication bias test.
A total of 17 studies with 906 participants were included. The gastric half-emptying time of solids (WMD, -10.4 minutes; P = 0.001; RoM, 0.90; P = 0.01) and liquids (WMD, -6.14 minutes; P < 0.001; RoM, 0.83, P = 0.03) was significantly shorter in individuals with obesity compared with lean individuals. These findings were confirmed by the subgroup analyses and publication bias tests.
Our pooled analysis systemically quantifies the differences in gastric half-emptying time between individuals with obesity and lean individuals, facilitating better understanding and prediction of drug absorption in individuals with obesity through physiologically based pharmacokinetic approaches. Obesity is associated with a faster transit of both solids and liquids through the stomach.
胃排空时间是决定口服给药药物药代动力学特性的限制因素之一。尽管全球肥胖症的患病率很高，但在这组患者中，胃排空时间的变化尚未得到系统的研究。本分析旨在定量研究肥胖患者与正常体重者相比，固体、半固体和液体的胃排空时间的相关变化，突出肥胖患者口服药物吸收的相关药代动力学意义。
我们在 Cochrane 图书馆、PubMed、Web of Science 和 Embase 中搜索了截至 2020 年 11 月 1 日发表的所有相关文章。通过加权均数差（WMD）和均数比（RoM）来量化肥胖和正常体重个体之间与胃排空相关的胃肠道变量的差异。通过亚组分析和发表偏倚检验来评估分析的稳健性。
共纳入 17 项研究，共 906 名参与者。肥胖个体的固体（WMD，-10.4 分钟；P = 0.001；RoM，0.90；P = 0.01）和液体（WMD，-6.14 分钟；P < 0.001；RoM，0.83，P = 0.03）的胃半排空时间明显短于正常体重个体。这些发现通过亚组分析和发表偏倚检验得到了证实。
我们的汇总分析系统地量化了肥胖个体与正常体重个体之间胃半排空时间的差异，通过基于生理的药代动力学方法，有助于更好地理解和预测肥胖个体的药物吸收。肥胖与固体和液体在胃内的通过速度均加快有关。
