Gastric emptying and release of incretin hormones after glucose ingestion in humans

被引:337
作者
Schirra, J
Katschinski, M
Weidmann, C
Schafer, T
Wank, U
Arnold, R
Goke, B
机构
[1] UNIV MARBURG,DEPT GASTROENTEROL & ENDOCRINOL,D-35033 MARBURG,GERMANY
[2] UNIV MARBURG,CLIN RES UNIT GASTROINTESTINAL ENDOCRINOL,D-35033 MARBURG,GERMANY
关键词
antroduodenal coordination; enteroinsular axis; gastrointestinal motility; glucagon-like peptide-1; glucose-dependent insulinotropic peptide;
D O I
10.1172/JCI118411
中图分类号
R-3 [医学研究方法]; R3 [基础医学];
学科分类号
1001 ;
摘要
This study investigated in eight healthy male volunteers (a) the gastric emptying pattern of 50 and 100 grams of glucose; (b) its relation to the phase of interdigestive motility (phase I or II) existing when glucose was ingested; and (c) the interplay between gastric emptying or duodenal perfusion of glucose (1.1 and 2.2 kcal/min; identical total glucose loads as orally given) and release of glucose-dependent insulinotropic peptide (GIP), glucagon-like peptide-1(7-36)amide (GLP-1), C-peptide, insulin, and plasma glucose, The phase of interdigestive motility existing at the time of glucose ingestion did not affect gastric emptying or any metabolic parameter, Gastric emptying of glucose displayed a power exponential pattern with a short initial lag period. Duodenal delivery of glucose was not constant but exponentially declined over time. Increasing the glucose load reduced the rate of gastric emptying by 27.5% (P < 0.05) but increased the fractional duodenal delivery of glucose, Both glucose loads induced a fed motor pattern which was terminated by an antral phase III when similar to 95% Of the meal had emptied. Plasma GLP-1 rose from basal levels of similar to 1 pmol/liter to peaks of 3.2 +/- 0.6 mol/liter with 50 grams of glucose and of 7.2 +/- 1.6 pmoll/liter with 100 grams of glucose. These peaks occurred 20 min after glucose intake irrespective of the load. A duodenal delivery of glucose exceeding 1.4 kcal/min was required to maintain GLP-1 release in contrast to ongoing GIP release with negligibly low emptying of glucose. Oral administration of glucose yielded higher GLP-1 and insulin releases but an equal GIP release compared with the isocaloric duodenal perfusion. We conclude that (a) gastric emptying of glucose displays a power exponential pattern with duodenal delivery exponentially declining over time and (b) a threshold rate of gastric emptying of glucose must be exceeded to release GLP-1, whereas GIP release is not controlled by gastric emptying.
引用
收藏
页码:92 / 103
页数:12
相关论文
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