脂肪诱导的人体回肠制动：一种与肽YY血浆水平相关的剂量依赖性现象。

Fat-induced ileal brake in humans: a dose-dependent phenomenon correlated to the plasma levels of peptide YY.

作者信息

Pironi L, Stanghellini V, Miglioli M, Corinaldesi R, De Giorgio R, Ruggeri E, Tosetti C, Poggioli G, Morselli Labate A M, Monetti N

机构信息

Institute of Internal Medicine and Gastroenterology, S. Orsola-Malpighi Hospital, University of Bologna, Italy.

出版信息

Gastroenterology. 1993 Sep;105(3):733-9. doi: 10.1016/0016-5085(93)90890-o.

DOI:10.1016/0016-5085(93)90890-o

PMID:8359644

Abstract

BACKGROUND

Upper gastrointestinal motility is regulated by the presence of nutrients in the distal gut. The present study evaluated whether lipid-induced ileal brake on gastric emptying (1) can be elicited by low fat concentrations; (2) is a dose-dependent phenomenon; and (3) is related to gastrointestinal peptide release.

METHODS

Seven patients were studied in the defunctionalized stage of total colectomy, on three separate occasions. On each study day, patients ate a meal labeled in the solid component; 30 minutes later, one of the following solutions was randomly infused into the ileal pouch: 0.9% saline, 2% oleic acid, and 20% oleic acid. Plasma concentrations of peptide YY (PYY), enteroglucagon, neurotensin, and motilin were measured.

RESULTS

Both oleic acid solutions slowed gastric emptying compared with saline (P < 0.001), the effect being dose dependent (P < 0.001). Ileal infusions did not modify neurotensin and enteroglucagon levels but induced a dose-dependent increase of PYY (P < 0.01) and a borderline decrease of motilin (P = 0.05) levels. Slower rates of gastric emptying were related to increased plasma concentrations of PYY (r = 0.615; P < 0.05).

CONCLUSIONS

This study shows that (1) the ileal brake on gastric emptying can be evoked by low doses of lipids in the distal ileum; (2) the delay of gastric emptying is related to the release of PYY; and (3) both phenomena are dose dependent.

摘要

背景

上消化道动力受远端肠道内营养物质的调节。本研究评估了脂肪诱导的回肠制动对胃排空的影响：（1）低脂肪浓度是否能引发这种制动；（2）是否为剂量依赖性现象；（3）是否与胃肠肽释放有关。

方法

对7例处于全结肠切除术后失功阶段的患者进行了3次独立研究。在每次研究日，患者进食固体成分标记的餐食；30分钟后，将以下溶液之一随机注入回肠袋：0.9%生理盐水、2%油酸和20%油酸。测量血浆中肽YY（PYY）、肠高血糖素、神经降压素和胃动素的浓度。

结果

与生理盐水相比，两种油酸溶液均减慢了胃排空（P<0.001），且该效应具有剂量依赖性（P<0.001）。回肠灌注未改变神经降压素和肠高血糖素水平，但诱导了PYY的剂量依赖性增加（P<0.01）和胃动素水平的临界降低（P=0.05）。胃排空减慢与血浆PYY浓度升高相关（r=0.615；P<0.05）。