THE ILEUM AND CARBOHYDRATE-MEDIATED FEEDBACK-REGULATION OF POSTPRANDIAL PANCREATICOBILIARY SECRETION IN NORMAL HUMANS

被引：45

作者：

JAIN, NK ^{[1
]}

BOIVIN, M ^{[1
]}

ZINSMEISTER, AR ^{[1
]}

DIMAGNO, EP ^{[1
]}

机构：

[1] MAYO CLIN & MAYO FDN,DIV GASTROENTEROL,GASTROINTESTINAL UNIT,ROCHESTER,MN 55905

来源：

PANCREAS | 1991年 / 6卷 / 05期

关键词：

TRYPSIN; AMYLASE; BILE ACIDS; STARCH; AMYLASE INHIBITOR;

D O I：

10.1097/00006676-199109000-00001

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

摘要：

We investigated the effect of perfusing carbohydrate into the ileum on postprandial pancreaticobiliary secretion and the relationships among carbohydrate in the ileum, pancreaticobiliary secretion, and gastric emptying. Eighteen healthy volunteers were intubated with a multilumen oroileal tube. A metal labeled with In-111-diethylenetriamine-pentaacetic acid (400 calories; 60% carbohydrate, 20% protein, 20% fat) was then infused into the stomach, and a carbohydrate solution (rice starch + glucose) was perfused into the terminal ileum at rates (mg/min) of 0 (saline; n = 6), 12.5 (n = 4), 25 (n = 4), 50 (n = 2), and 100 (n = 2). To prevent digestion of the carbohydrate in the ileum, an amylase inhibitor (3.3 mg/ml) was added to the perfusate used in half of the subjects. Postprandially, we measured outputs of amylase, trypsin, and bile acids in the duodenum, the amount of carbohydrate in the ileum, and gastric emptying. During the second postprandial hour the rate of gastric emptying was inversely related to the amount of carbohydrate in the ileum (p < 0.01) and was directly correlated with pancreaticobiliary secretion (p < 0.05). However, as the amount of unabsorbed carbohydrate in the ileum increased, the ratio of amylase to trypsin secretion increased (p < 0.005). Postprandially carbohydrate in the ileum induces changes of upper-gut function that should increase digestion and absorption of carbohydrate since gastric emptying (and delivery of carbohydrate to the duodenum) slows and pancreatic amylase secretion increases relative to trypsin secretion and gastric emptying.

引用

页码：495 / 505

页数：11

共 46 条

[1]

Jain N., Boivin M., Zinsmeister A.R., Go V., Dimagno E.P., Carbohydrate (CHO) mediated feedback regulation of postprandial pancreatic enzyme secretion in normal humans, Dig Dis Sci, 31, (1986)

[2]

Cooke A.R., Localization of receptors inhibiting gastric emptying in the gut, Gastroenterology, 72, pp. 875-880, (1977)

[3]

Valenzuela J.E., Defilippi C., Inhibition of gastric emptying in humans by secretin, the octapeptide of cholecystokinin and intraduodenal fat, Gastroenterology, 81, pp. 898-902, (1981)

[4]

Holgate A.M., Read N.W., Effect of ileal infusion of intralipid on gastrointestinal transit, ileal flow rate and carbohydrate absorption in humans after ingestion of a lipid meal, Gastroenterology, 88, pp. 1003-1011, (1985)

[5]

Read N.W., Macfarlane A., Kinsman R.I., Et al., Effect of infusion of nutrient solutions into the ileum on gastrointestinal transit and plasma levels of neurotensin and enteroglucagon, Gastroenterology, 86, pp. 274-280, (1984)

[6]

Brener W., Hendrix T.R., McHugh P.R., Regulation of gastric emptying of glucose, Gastroenterology, 85, pp. 76-82, (1983)

[7]

Miller L.J., Malagelada J.R., Taylor W.F., Go V., Intestinal control of human postprandial gastric function: The role of components of jejunoileal chyme in regulating gastric secretion and gastric emptying, Gastroenterology, 80, pp. 763-769, (1981)

[8]

Jain N.K., Boivin M., Zinsmeister A.R., Brown M.L., Malagelada J.R., Dimagno E.P., Effect of perfusing carbohydrates and amylase inhibitor into the ileum on gastrointestinal hormones and gastric emptying of a homogenized meal, Gastroenterology, 96, pp. 377-387, (1989)

[9]

Go V., Hofmann A.F., Summerskill W., Pancreozymin bioassay in man based on pancreatic enzyme secretion: Potency of specific amino acids and other digestive products, J Clin Invest, 49, (1970)

[10]

Dimagno E.P., Go V., Summerskill W., Impaired CCK-PZ secretion, intraluminal dilution and maldigestion of fat in sprue, Gastroenterology, 63, pp. 25-32, (1972)

← 1 2 3 4 5 →