Gastric emptying, mouth-to-cecum transit, and glycemic, insulin, incretin, and energy intake responses to a mixed-nutrient liquid in lean, overweight, and obese males

Abstract

Seimon RV, Brennan IM, Russo A, Little TJ, Jones KL, Standfield S, Wishart JM, Horowitz M, Feinle-Bisset C. Gastric emptying, mouth-to-cecum transit, and glycemic, insulin, incretin, and energy intake responses to a mixed-nutrient liquid in lean, overweight, and obese males. Am J Physiol Endocrinol Metab 304: E294 -E300, 2013. First published December 4, 2012; doi:10.1152/ajpendo.00533.2012.-Observations relating to the impact of obesity on gastric emptying (GE) and the secretion of gut hormones are inconsistent, probably because of a lack of studies in which GE, gastrointestinal hormone release, and energy intake (EI) have been evaluated concurrently with previous patterns of nutrient intake. GE is known to be a major determinant of postprandial glycemia and incretin secretion in health and type 2 diabetes. The aims of this study were to determine the effects of a mixed-nutrient drink on GE, oro-cecal transit, blood glucose, insulin and incretin concentrations and EI, and the relationship between the glycemic response to the drink with GE in lean, overweight, and obese subjects. Twenty lean, 20 overweight, and 20 obese males had measurements of GE, oro-cecal transit, and blood glucose, insulin, GLP-1, and GIP concentrations for 5 h after ingestion of a mixed-nutrient drink (500 ml, 532 kcal); EI at a subsequent buffet lunch was determined. Habitual EI was also quantified. Glycemic and insulinemic responses to the drink were greater in the obese (both P Ͻ 0.05) when compared with both lean and overweight, with no significant differences in GE, intragastric distribution, oro-cecal transit, incretins, or EI (buffet lunch or habitual) between groups. The magnitude of the rise in blood glucose after the drink was greater when GE was relatively more rapid (r ϭ Ϫ0.55, P Ͻ 0.05). In conclusion, in the absence of differences in habitual EI, both GE and incretin hormones are unaffected in the obese despite greater glucose and insulin responses, and GE is a determinant of postprandial glycemia.glucagon-like peptide-1; glucose-dependent insulinotropic peptide; habitual food intake; blood glucose control GASTROINTESTINAL (GI) function, including pyloric activity, gastric emptying (GE), and intragastric meal distribution, is pivotal to the regulation of appetite (36) and blood glucose homeostasis (20) and accordingly is of relevance to an understanding of the pathogenesis, and for rational management, of obesity. Moreover, macronutrient intake per se modulates GI function and thus potentially appetite regulation in both animals and humans. For example, in rats, exposure to a high-fat diet attenuates the suppressive effects of small intestinal fat on GE (11) and energy intake (12), and there is evidence that the sensitivity to the effects of fat on GI function and energy intake is reduced by a high-fat diet (4,14). Although specific aspects of GI function in the obese have been investigated in a number of studies, there is a lack of studies that have evaluated changes in GI function in lean, overweight, and obese individuals,...

Effects of Sitagliptin on Glycemia, Incretin Hormones, and Antropyloroduodenal Motility in Response to Intraduodenal Glucose Infusion in Healthy Lean and Obese Humans and Patients With Type 2 Diabetes Treated With or Without Metformin

“…In both obesity (10,11) and type 2 diabetes (12,13), postprandial GLP-1 responses have been inconsistently reported to be reduced after oral nutrients and those of GIP to be intact. However, even in health, the overall rate of gastric emptying varies from 1 to 4 kcal/min (14), and patients with long-standing type 2 diabetes frequently have accelerated or delayed gastric emptying (15).…”

Gastric emptying rate, glycemic and appetite response to a liquid meal in lean and overweight males

“…The effect of body weight status on gastric emptying rate was studied by Seimon et al (2013) and it was found that body weight status did not influence gastric emptying. However, previous animal studies have revealed a negative association between body weight and gastric emptying rate (Bourreau et al, 2004;Kristiansen, 1998).…”

“…While this makes the results more generalizable to a wider population, it may also mask potential different responses between lean and overweight participants. To date, only a limited number of studies have investigated the difference in appetite responses between overweight and lean participants; the results remain inconclusive (Brondel et al, 2007;Coelho et al, 2006;Lomenick et al, 2008;Seimon et al, 2013). Different study design, test foods and study populations may have partly accounted for the conflicting results.…”

1316 Glucose-Induced Glucagon-Like Peptide 1 Secretion Is Deficient in Patients With Non-Alcoholic Fatty Liver Disease

“…Some studies found impaired early GLP-1 secretion in response to a mixed meal or glucose in IR [30,31], others reported normal GLP-1 secretion [27]. There is however, some evidence that GLP-1 secretion is not impaired in obese compared to lean subjects [32][33][34].…”

“…Experimental data suggest a link between GLP-1 and steatogenesis. Prevention or reversal of hepatic steatosis by different GLP-1 agonists including exendin-4 [11,12], liraglutide [13,14], GLP-1 (28)(29)(30)(31)(32)(33)(34)(35)(36)amide [15], and AC3174 [16] has been shown in rodents. There is evidence for the presence of GLP-1R on human hepatocytes [12,17].…”