Modulation of individual components of gastric motor response to duodenal glucose

摘要

AIM:To evaluate individual components of the antro-pyloro-duodenal(APD)motor response to graded small intestinal glucose infusions in healthy humans.METHODS:APD manometry was performed in 15healthy subjects(12 male;40±5 years,body mass index 26.5±1.6 kg/m2)during four 20-min intraduodenal infusions of glucose at 0,0.5,1.0 and 1.5 kcal/min,in a randomised double-blinded fashion.Glucose solutions were infused at a rate of 1 mL/min and separated by 40-min"wash-out"period.Data are mean±SE.Inferential analyses are repeated measure analysis of variance with Bonferroni post-hoc testing.RESULTS:At 0 kcal/min frequency of pressure waves were:antrum(7.5±1.8 waves/20 min)and isolated pyloric pressure waves(IPPWs)(8.0±2.3 waves/20min)with pyloric tone(0.0±0.9 mmHg).Intraduodenal glucose infusion acutely increased IPPW frequency(P<0.001)and pyloric tone(P=0.015),and decreased antral wave frequency(P=0.007)in a dosedependent fashion.A threshold for stimulation was observed at 1.0 kcal/min for pyloric phasic pressure waves(P=0.002)and 1.5 kcal/min for pyloric tone and antral contractility.CONCLUSION:There is hierarchy for the activation of gastrointestinal motor responses to duodenal glucose infusion.An increase in IPPWs is the first response observed.