Gastric Emptying of Solids and Semi-solids in Morbidly Obese and Non-obese Subjects: An Assessment Using the 13C-Octanoic Acid and 13C-Acetic Acid Breath Tests

Cardoso-Júnior, Aloísio; Coelho, Luiz Gonzaga Vaz; Savassi-Rocha, Paulo Roberto; Vignolo, Maria Cristina; Abrantes, Marcelo Militão; Almeida, Aline Miranda de; Dias, Emanuela Eudes; Júnior, Gerival Vieira; Castro, Mirian Cabral Moreira de; Lemos, Yara Vieira

doi:10.1007/s11695-007-9031-4

Cited by 71 publications

(52 citation statements)

References 28 publications

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“…LBW* LBW calculated by Janmahasatians formulae minus blood weight to give a blood-free LBW consensus over changes in gastric emptying time among obese patients. Some authors have identified faster gastric emptying time among the obese, mainly with solid foods, which could reduce the effectiveness of decontamination [33][34][35]. However, in other studies, obese patients were found to have delayed gastric emptying time [36,37].…”

Section: Gastrointestinalmentioning

confidence: 99%

A Review of the Toxicologic Implications of Obesity

2015

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The increasing prevalence of obesity in developed nations has far-reaching implications for medical toxicology. The management of obese patients is complicated by comorbid illnesses, changes in cardiovascular and respiratory physiology, alterations in pharmacokinetics, and a lack of studies to identify appropriate dosing for current therapeutics and antidotes. In this review article, we examine obesity-associated physiologic and pharmacokinetic changes that may increase the vulnerability of obese patients to overdose. Further research is needed to characterize the relationship between drug toxicity and obesity.

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Section: Gastrointestinalmentioning

confidence: 99%

A Review of the Toxicologic Implications of Obesity

2015

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“…As a quantitative determinator of food intake (16,23), gastric emptying is fine-tuned by metabolic, neuronal, and hormonal signals. Gastric emptying is positively associated with overeating (16) and is enhanced in obese subjects (8,52). Peripheral GLP-2 inhibits (Ϫ75%) gastric antral motility in humans (35) and pigs (51).…”

Section: E861mentioning

confidence: 99%

“…Faster GE results in shorter satiety period and overeating (23) and is considered a major cause of obesity (16). GE is enhanced in obese subjects (8,52). Orexigenic peptides (e.g., ghrelin) increase GE, whereas anorexigenic peptides (e.g., leptin) decrease it (7,9).…”

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confidence: 99%

GLP-2 receptor in POMC neurons suppresses feeding behavior and gastric motility

Guan

Shi

et al. 2012

American Journal of Physiology-Endocrinology and Metabolism

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receptor in POMC neurons suppresses feeding behavior and gastric motility. Am J Physiol Endocrinol Metab 303: E853-E864, 2012. First published July 24, 2012; doi:10.1152/ajpendo.00245.2012.-Glucagon-like peptides (GLP-1/2) are cosecreted from endocrine L cells in the gut and preproglucagonergic neurons in the brain. Peripheral GLP-2 action is essential for maintaining intestinal homeostasis, improving absorption efficiency and blood flow, promoting immune defense, and producing efficacy in treatment of gastrointestinal diseases. However, it is unknown if CNS GLP-2 plays a physiological role in the control of energy homeostasis. Since GLP-1/2 are cotranslated from preproglucagongene and coproduced by prohormone convertase-1, it is challenging to knockout GLP-2 only. Instead, our laboratory has generated a Glp2r-floxed mouse line to dissect cellspecific GLP-2 receptor GLP-2R) action in the regulation of energy balance. Our objective was to determine if GLP-2R in the hypothalamus modulates feeding behavior and gastric emptying. We show that Glp2r mRNA and protein are highly expressed in the arcuate nucleus and dorsomedial nucleus of the mouse hypothalamus. Using the Cre-LoxP system, we generated mice that lack Glp2r expression in POMC neurons (KO; mainly in the hypothalamus). The KO mice showed hyperphagic behavior (such as increases in food intake and meal frequency), accelerated gastric emptying (assessed by [ 13 C]octanoic acid breath test), and late-onset obesity, yet there was no decrease in basal metabolic rate. Infusion of GLP-2 (2.5 nmol into the 4th ventricle) suppressed food intake and gastric emptying, while GLP-2-mediated effects were abolished in the melanocortin receptor-4 (MC4R) KO mice. We conclude that Glp2r deletion in POMC neurons enhances feeding behavior and gastric motility, whereas icv GLP-2R activation suppresses food intake and gastric emptying through the MC4R signaling pathway. This study indicates that CNS GLP-2R plays a physiological role in the control of feeding behavior and gastric emptying and that this is mediated probably through the melanocortin system. glucagon-like peptides; proopiomelanocortin; energy homeostasis; food intake; gastric emptying OBESITY AND TYPE 2 DIABETES affect millions of people and are major health problems in the United States. The hypothalamus, a primary site of convergence and integration in the brain for hormonal and nutritional signals, plays pivotal roles in the regulation of energy balance (42). In the arcuate nucleus (ARC) of the hypothalamus, neurons expressing proopiomelanocortin (POMC neurons) are perfectly positioned to integrate long-term adiposity and short-term satiety signals for energy homeostasis (12). POMC neuronal activation enhances energy expenditure and suppresses food intake, yet neuroendocrine mechanisms are not fully established. Notably, the gastrointestinal (GI) tract has a crucial role in digestion, absorption, and assimilation of nutrients (15), thus controlling energy intake at the first pass. Through the gut-brain axis, gut ho...

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“…There is a school of thought that this increased GE caused by an HF diet can reduce the ability of the stomach to retain chyme causing reduced satiety, increased food intake (French et al, 1995;Boyd et al, 2003) and subsequent obesity. This may explain the accelerated GE that has been observed in obese individuals (Cardoso-Junior et al, 2007;Clegg and Shafat, 2009). Following the 2 weeks HF diet, satiety recorded through food diaries and visual analogue scales (VAS) showed tendencies towards decreased fullness, increased hunger and increased food intake after 2 weeks on an HF diet (French et al, 1995).…”

Section: Introductionmentioning

confidence: 95%

Gastrointestinal transit, post-prandial lipaemia and satiety following 3 days high-fat diet in men

Clegg

McKenna²,

McClean

et al. 2010

Eur J Clin Nutr

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Background/Objectives: High-fat (HF) diets of 2 weeks have been shown to accelerate gastric emptying (GE). To date, no studies have shown any alteration in GE following shorter HF diets. The aim of this study was to assess if an HF, high-energy diet of 3 days can adapt gastrointestinal (GI) transit, blood lipids and satiety. Subjects/Methods: Eleven male volunteers participated in a study consisting of three, 3-day interventions each separated by a test day. During the first intervention, volunteers recorded their diet. In the second and third interventions, volunteers repeated their food diary plus either a low-fat yogurt or HF yogurt supplement in randomized order. Test days involved measurement of GE using the 13 C octanoic-acid breath-test, mouth-to-caecum transit time (MCTT) using the inulin H 2 breath test and satiety using visual analogue scales. Blood samples for measurement of lipaemia were taken using a venous cannula. Results: MCTT was different between the three test days (P ¼ 0.038), with the shortest MCTT following the HF intervention. GE was shortest following the HF intervention. There were no differences in satiety between the interventions. The HF intervention reduced triglycerides, total cholesterol and low-density lipoprotein cholesterol, and increased high-density lipoprotein cholesterol. Conclusion: This study shows that changes in GI transit owing to an HF diet can occur in a time period as short as 3 days.

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Gastric Emptying of Solids and Semi-solids in Morbidly Obese and Non-obese Subjects: An Assessment Using the 13C-Octanoic Acid and 13C-Acetic Acid Breath Tests

Cited by 71 publications

References 28 publications

A Review of the Toxicologic Implications of Obesity

A Review of the Toxicologic Implications of Obesity

GLP-2 receptor in POMC neurons suppresses feeding behavior and gastric motility

Gastrointestinal transit, post-prandial lipaemia and satiety following 3 days high-fat diet in men

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