Clinical and Experimental Endocrinology, Department of Chronic Diseases and Metabolism, KU Leuven, Leuven, Belgium.
Translational Research Center for Gastrointestinal Disorders, Department of Chronic Diseases and Metabolism, KU Leuven, Leuven, Belgium.
Neurogastroenterol Motil. 2024 Apr;36(4):e14758. doi: 10.1111/nmo.14758. Epub 2024 Feb 11.
The pathophysiology of obesity has been the product of extensive research, revealing multiple interconnected mechanisms contributing to body weight regulation. The regulation of energy balance involves an intricate network, including the gut-neuroendocrine interplay. As a consequence, research on the gut-brain-microbiota axis in obesity has grown extensively. The physiology of the gastrointestinal tract, far from being underexplored, has significant implications for the development of specific complications in people living with obesity across the fields of gastroenterology, nutrition, and pharmacology. Clinical research indicates higher fasting bile acids serum levels, and blunted postprandial increases in bilious secretions in people living with obesity. Findings are less straightforward for the impact of obesity on gastric emptying with various studies reporting accelerated, normal, or delayed gastric emptying rates. Conversely, the effect of obesity on gastrointestinal pH, gastrointestinal transit, and gastric and pancreatic enzyme secretion is largely unknown. In this review, we explore the current evidence on the gastrointestinal physiology of obesity.
肥胖的病理生理学是广泛研究的产物，揭示了多种相互关联的机制，这些机制有助于体重调节。能量平衡的调节涉及一个复杂的网络，包括肠道-神经内分泌的相互作用。因此，肥胖症中肠道-脑-微生物群轴的研究已经广泛开展。胃肠道的生理学远非未被充分探索，它对肥胖人群在胃肠病学、营养学和药理学领域出现特定并发症的发展具有重要意义。临床研究表明，肥胖人群空腹胆汁酸血清水平较高，餐后胆汁分泌增加减弱。而肥胖对胃排空的影响则不那么明确，不同的研究报告加速、正常或延迟的胃排空率。相反，肥胖对胃肠道 pH 值、胃肠道转运和胃和胰腺酶分泌的影响则知之甚少。在这篇综述中，我们探讨了肥胖症的胃肠道生理学的现有证据。
