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

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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

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Authors and Affiliations

  1. Department of Gastroenterology and Hepatology, Level 7, Royal Adelaide Hospital, North Terrace, Adelaide, SA, 5000, Australia

    Nam Q Nguyen, Tamara L Debreceni & Jenna E Burgess

  2. Discipline of Medicine, University of Adelaide, Royal Adelaide Hospital, Level 6 Eleanor Harrold Building, North Terrace, Adelaide, SA, 5000, Australia

    Nam Q Nguyen, Judith Wishart, Scott Standfield & Michael Horowitz

  3. Nuclear Medicine, PET and Bone Densitometry, Royal Adelaide Hospital, Adelaide, SA, Australia

    Max Bellon

  4. Department of GI Physiology, INRA, Paris, France

    Charles-Henri Malbert

Authors
  1. Nam Q Nguyen
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Correspondence to Nam Q Nguyen.

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Nguyen, N.Q., Debreceni, T.L., Burgess, J.E. et al. Impact of gastric emptying and small intestinal transit on blood glucose, intestinal hormones, glucose absorption in the morbidly obese. Int J Obes 42, 1556–1564 (2018). https://doi.org/10.1038/s41366-018-0012-6

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  • DOI: https://doi.org/10.1038/s41366-018-0012-6

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