Interdigestive Gastroduodenal Motility and Cycling of Putative Regulatory Hormones in Severe Obesity

Abstract

The aim of the present study was to evaluate interdigestive gastrointestinal motility and its coordination with plasma concentrations of motilin and pancreatic polypeptide (PP) in 14 patients with severe obesity and in 10 control subjects with normal body weight. Motor activity of the stomach, duodenum, and proximal jejunum was recorded by using an eight-lumen catheter. Blood samples were drawn for determination of interdigestive motilin and PP plasma concentrations. We observed no difference in total duration of the migrating motor complex (MMC) or of phases I, II, or III of the MMC. Gastric phase-III activity occurred less frequently in severely obese patients (only 15% originating in the stomach) than in controls (65%; p less than 0.01). Plasma motilin concentrations were decreased in obese patients in phase I (127 +/- 17 pg/ml in controls versus 87 +/- 10 pg/ml in obese), in phase II (189 +/- 26 pg/ml controls versus 134 +/- 15 obese) and in phase III (195 +/- 29 pg/ml controls versus 153 +/- 28 pg/ml obese). Peak motilin release occurred in synchrony with phase-III activity and was greater in controls than in obese patients. Plasma PP concentrations did not differ from those of controls during any phase of the MMC. These results further suggest a potential role for motilin in regulating gastrointestinal motor activity and indicate a potential defect in this regulatory mechanism in severe obesity. Whether the relationship between disordered motor activity and motilin release is etiologic with regard to the pathophysiology of obesity remains to be determined.

Redefining the functional roles of the gastrointestinal migrating motor complex and motilin in small bacterial overgrowth and hunger signaling

“…Although plasma levels were overall higher in the obese patients the fluctuation of motilin plasma levels was diminished (19). Our findings of elevated motilin levels are in agreement with two other studies reporting significantly higher motilin plasma levels in obesity (15,40,59). Hunger measurements showed lower hunger scores during phase III in the obese compared with the healthy controls, which is probably due to the shift in origin from gastric to duodenal, despite the higher motilin plasma levels (19).…”

“…In 1992 Pieramico et al (40) reported that obese patients had significantly fewer phase III contractions that started in the stomach compared with healthy controls. This change in origin was associated with significantly lower motilin plasma levels in the obese patients compared with the lean controls.…”

Increased Prevalence of Obesity in Children With Functional Constipation Evaluated in an Academic Medical Center

“…Circulating hormones have been implicated in adult constipation 8 and in severe obesity. 9 Therefore, reasons for this association could be multifactorial, including diet, activity level, or hormonal influences, and require additional studies.…”

Proximal Gastric Motility Functions Are Normal in Severe Obesity

“…Basel U 0012-2823/97/0582-0115S12.00/0 E-Mail karger^'kargcr.ch F ax+ 41 61 306 12 34 http:// www. karger, ch nied by decreased plasma motilin concentrations at all phases of the migrating motor complex as compared with controls, but by a normal secretion of pancreatic polypep tide [6]. Whether these findings contribute to the etiology of obesity is not clear [6].…”