Impact of gastric emptying and small intestinal transit on blood glucose, intestinal hormones, glucose absorption in the morbidly obese.

Abstract

OBJECTIVE:

This study evaluated gastric emptying (GE) and small intestinal (SI) transit in people with morbid obesity and their relationships to glycaemia, incretin hormones, and glucose absorption METHODS: GE and caecal arrival time (CAT) of a mixed meal were assessed in 22 morbidly obese (50.2 ± 2.5 years; 13 F:9 M; BMI: 48.6 ± 1.8 kg/m2) and 10 lean (38.6 ± 8.4 years; 5 F:5 M; BMI: 23.9 ± 0.7 kg/m2) subjects, using scintigraphy. Blood glucose, plasma 3-O-methylglucose, insulin, glucagon, glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1) were measured. Insulin sensitivity and resistance were also quantified RESULTS: When compared with lean subjects, GE (t50: 60.7 ± 6.5 vs. 41.1 ± 7.3 min; P  = 0.04) and CAT (221.5 ± 9.8 vs. 148.0 ± 7.1 min; P =  0.001) of solids were prolonged in morbid obesity. Postprandial rises in GIP (P = 0.001), insulin (P  = 0.02), glucose (P = 0.03) and 3-O-methylglucose (P = 0.001) were less. Whereas GLP-1 increased at 45 mins post-prandially in lean subjects, there was no increase in the obese (P  = 0.04). Both fasting (P = 0.045) and postprandial (P = 0.012) plasma glucagon concentrations were higher in the obese CONCLUSIONS: GE and SI transit are slower in the morbidly obese, and associated with reductions in postprandial glucose absorption, and glycaemic excursions, as well as plasma GIP and GLP-1.

• Authors: Nam Q Nguyen, Tamara L Debreceni, Jenna E Burgess, Max Bellon, Judith Wishart, Scott Standfield, Charles-Henri Malbert, Michael Horowitz
• Journal: International journal of obesity (2005) (Int J Obes (Lond)) Vol. 42 Issue 9 Pg. 1556-1564 (09 2018) ISSN: 1476-5497 [Electronic] England
• PMID: 29453463 (Publication Type: Journal Article)

Chemical References

• Blood Glucose
• Gastrointestinal Hormones

Topics

• Adult
• Blood Glucose (metabolism)
• Female
• Gastric Emptying (physiology)
• Gastrointestinal Hormones (metabolism)
• Gastrointestinal Transit (physiology)
• Humans
• Intestine, Small (metabolism)
• Male
• Middle Aged
• Obesity, Morbid (metabolism, physiopathology)
• Radionuclide Imaging