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急性高血糖对人体结肠运动和感觉功能的影响。

Effect of acute hyperglycemia on colorectal motor and sensory function in humans.

作者信息

Maleki D, Camilleri M, Zinsmeister A R, Rizza R A

机构信息

Division of Endocrinology, Metabolism, and Nutrition, Mayo Clinic and Mayo Foundation, Rochester, Minnesota 55905, USA.

出版信息

Am J Physiol. 1997 Oct;273(4):G859-64. doi: 10.1152/ajpgi.1997.273.4.G859.

Abstract

Increased use of laxatives and constipation are more common among people with diabetes mellitus than matched nondiabetic people in the same community. The mechanism of constipation in diabetes is unclear. Acute hyperglycemia was previously reported to reduce the gastrocolonic response. Our aim was to determine the effects of acute hyperglycemia on the colon compliance and motor response to feeding and on the sensory function of the colon and rectum in healthy human subjects. Eleven healthy individuals were studied under conditions of hyperglycemia (mean blood glucose 280 +/- 13 mg/dl) and euglycemia. We evaluated three parameters: 1) colonic motility and compliance by a multilumen manometry and barostatic balloon assembly in the descending colon (motility was studied during fasting and for 2 h postprandially); 2) perception of isobaric distensions of polyethylene balloons in the rectum and colon; and 3) rectal compliance. Initial tonic response to meal ingestion (0-5 min) was slightly lower during hyperglycemia (P = 0.3). However, colonic tone, motility, compliance, and sensation, as well as rectal compliance and sensation, were not significantly different under the conditions of euglycemia and acute hyperglycemia. In healthy individuals, acute hyperglycemia does not significantly change colonic or rectal motor functions or the perception of mechanosensory stimuli in the colon or rectum compared with euglycemia. These results do not support the hypothesis that hyperglycemia abolishes the colonic response to feeding.

摘要

与同一社区中匹配的非糖尿病患者相比,糖尿病患者中泻药使用增加和便秘更为常见。糖尿病中便秘的机制尚不清楚。先前有报道称急性高血糖会降低胃结肠反射。我们的目的是确定急性高血糖对健康受试者结肠顺应性、对进食的运动反应以及结肠和直肠感觉功能的影响。对11名健康个体在高血糖(平均血糖280±13mg/dl)和血糖正常的条件下进行了研究。我们评估了三个参数:1)通过降结肠中的多腔测压法和恒压气囊组件评估结肠运动性和顺应性(在禁食期间和餐后2小时研究运动性);2)直肠和结肠中聚乙烯气囊等压扩张的感觉;3)直肠顺应性。在高血糖期间,对进餐摄入的初始紧张反应(0 - 5分钟)略低(P = 0.3)。然而,在血糖正常和急性高血糖条件下,结肠张力、运动性、顺应性和感觉,以及直肠顺应性和感觉并无显著差异。与血糖正常相比,在健康个体中,急性高血糖不会显著改变结肠或直肠的运动功能或结肠或直肠中机械感觉刺激的感知。这些结果不支持高血糖会消除结肠对进食反应的假说。

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