AIM: To determine the relative potency and contribution of intestinal nutrients to net gastric accommodative relaxation and conscious perception. METHODS: In 12 healthy subjects, we randomly tested duodenal loads of...AIM: To determine the relative potency and contribution of intestinal nutrients to net gastric accommodative relaxation and conscious perception. METHODS: In 12 healthy subjects, we randomly tested duodenal loads of lipids and carbohydrates (12 mL administered in 4 rain) at various caloric concentrations (0.0125-0.8 kcal/mL) separated by 12-24 rain wash-out periods of saline infusion. Maximal gastric relaxation was induced at the end of each experiment by i.v glucagon (5 μg/kg), as reference. The reflex gastric response was measured by a barostat, and symptom perception by a 0-6 score questionnaire. RESULTS: Upids induced a dose-response gastric relaxation with a steep and early rise. Maximal effect (179±42 mL relaxation) reached at a relatively low concentration (0.2 kcal/mL), maximal lipid-induced relaxation was 61±6% of the glucagon effect. By contrast, duodenal infusion of carbohydrates induced weaker relaxation that became significant only at the high end of the physiological concentration range (65±14 ml with 0.8 kcal/mL). Intestinal nutrient loads, either of lipid or carbohydrates, did not induce significant changes in perception (0.6±0.4 and 0.1±0.4 score increase for the highest concentrations, respectively). CONCLUSION: Chyme entering the small bowel induces nutrient-spedfic gastric relaxatory reflexes by a physiologically saturable mechanism. Normally, neither the intestinal nutrient load nor the gastric accommodative response is perceived.展开更多
基金Supported by the Spanish Ministry of Education (Direccion General de Ensenanza Superior del Ministerio de Educaci6ny Culture, BFI 2002-03413)the Instituto de Salud Carlos m, No. C03/02the National Institutes of Health, USA, No. DK 57064
文摘AIM: To determine the relative potency and contribution of intestinal nutrients to net gastric accommodative relaxation and conscious perception. METHODS: In 12 healthy subjects, we randomly tested duodenal loads of lipids and carbohydrates (12 mL administered in 4 rain) at various caloric concentrations (0.0125-0.8 kcal/mL) separated by 12-24 rain wash-out periods of saline infusion. Maximal gastric relaxation was induced at the end of each experiment by i.v glucagon (5 μg/kg), as reference. The reflex gastric response was measured by a barostat, and symptom perception by a 0-6 score questionnaire. RESULTS: Upids induced a dose-response gastric relaxation with a steep and early rise. Maximal effect (179±42 mL relaxation) reached at a relatively low concentration (0.2 kcal/mL), maximal lipid-induced relaxation was 61±6% of the glucagon effect. By contrast, duodenal infusion of carbohydrates induced weaker relaxation that became significant only at the high end of the physiological concentration range (65±14 ml with 0.8 kcal/mL). Intestinal nutrient loads, either of lipid or carbohydrates, did not induce significant changes in perception (0.6±0.4 and 0.1±0.4 score increase for the highest concentrations, respectively). CONCLUSION: Chyme entering the small bowel induces nutrient-spedfic gastric relaxatory reflexes by a physiologically saturable mechanism. Normally, neither the intestinal nutrient load nor the gastric accommodative response is perceived.