Radioisotopic assessment of gastric emptying of solids in elderly subjects

Brogna, A; Loreno, Massimiliano; Crea, Filippo; Bucceri, A.; Malaguarnera, Mariano; Muratore, Liboria Agata; Travali, Salvatore

doi:10.1007/bf03324849

Cited by 33 publications

(17 citation statements)

References 29 publications

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“…According to the Brogna et al study [2], the normal emptying time values are in the range from 30 to 76 min (53 ± 23 min), which suggests an agreement with those values obtained in this study by using both methods. Scintigraphy shows a better SD (12.9 min) than the 23 min reported, while the SD (25.8 min) for MMG is not far from the scintigraphy value.…”

Section: Discussionsupporting

confidence: 90%

Scintigraphy vs. mechanical magnetogastrography: gastric emptying analysis

Roca-Chiapas

Córdova–Fraga

Reynaga-Ornelas

et al. 2010

Med Biol Eng Comput

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Scintigraphy technique is considered the gold standard for gastric emptying evaluations. Lately mechanical magnetogastrography (MMG) technique has emerged as an alternative for these assessments. This study presents the determination of reference values for MMG in order to validate this novel technique in gastric emptying measurements. Both methodologies were used in young and healthy subjects provided with a solid test meal. The measurements were performed with 2 days of difference. Bland-Altman analysis of the data was performed to conclude about the feasibility of MMG as a good alternative test for gastric emptying assessments. Using MMG, an average of the gastric emptying half-time of 57.6 +/- 25.8 min was obtained, whereas the same parameter obtained by scintigraphy was 52.2 +/- 12.9 min. In conclusion, the use of MMG technique is in concordance with the results using the gold standard technique for gastric emptying measurements.

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Section: Discussionsupporting

confidence: 90%

Scintigraphy vs. mechanical magnetogastrography: gastric emptying analysis

Roca-Chiapas

Córdova–Fraga

Reynaga-Ornelas

et al. 2010

Med Biol Eng Comput

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“…Potential mechanisms are reduced beta cell mass or limited beta cell function due to islet accumulation of amyloid, lipotoxicity, the actions of circulating adipocytokines, or a diminished effect of incretin hormones [4,5]. Alternative explanations for a negative association between age and serum insulin could be that older people preferentially eat meals that are smaller or have a composition to trigger less insulin release, or have slower rates of gastric emptying [35] and delayed nutrient absorption. Other causes could be selective mortality in elderly persons with elevated insulin due to impaired insulin action, or lower attendance rates in the older age groups because of illnesses associated with insulin resistance.…”

Section: Discussionmentioning

confidence: 99%

Associations of age with serum insulin, proinsulin and the proinsulin-to-insulin ratio: a cross-sectional study

2010

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BackgroundInsulin responses and insulin levels seem to decline with age. However, the question of beta cell impairment attributable to ageing has been sparsely addressed in population-based studies. Non-fasting insulin levels are determined by the ambient degree of insulin resistance together with the capacity of beta cells to compensate by insulin secretion to prevent hyperglycaemia. A raised proinsulin-to-insulin ratio (proinsulin/insulin) due to impaired processing of proinsulin is an early marker of beta cell dysfunction. We hypothesised that in a general population, signs of beta cell failure with advancing age manifest not only by decreases in random insulin, but also with a corresponding increase in its precursor proinsulin.MethodsIn the Tromsø Study 1994-95 we measured insulin and proinsulin concentrations in random blood samples from 6212 persons without self-reported diabetes mellitus and plotted the levels as percentiles according to age. In regression analyses we assessed the relationships between age and insulin, proinsulin, and proinsulin/insulin, while adjusting for the concomitant measurements of glucose and other metabolic variables, and the time since the last meal.ResultsMedian insulin concentrations declined significantly with advancing age group in men, but not in women. Proinsulin levels and proinsulin/insulin increased across age groups in both genders. After adjustment, greater age was associated with lower log10(insulin) and higher log10(proinsulin) and log10(proinsulin/insulin) (p = 0.0001 for all).ConclusionsNegative associations of age with random insulin levels, together with positive associations of age with proinsulin and proinsulin/insulin, point towards a loss of beta cell function inherent in the ageing process.

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“…Male and female patients 18–60 years of age, meeting specific inclusion and exclusion criteria, were eligible for enrollment. Although age between 18 and 60 years does not appear to influence GE (21), there is evidence that age >60 years delays GE of solids and 5% glucose drinks (22–25). …”

Section: Methodsmentioning

confidence: 99%

Randomized Controlled Phase Ib Study of Ghrelin Agonist, RM-131, in Type 2 Diabetic Women With Delayed Gastric Emptying

et al. 2012

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OBJECTIVETo investigate the pharmacokinetics (PK), pharmacodynamics, and safety of single-dose RM-131 in type 2 diabetic patients with gastrointestinal cardinal symptoms (GCSI) and previously documented delayed gastric emptying (DGE).RESEARCH DESIGN AND METHODSIn a randomized crossover study, 10 female patients received RM-131 (100 μg s.c.) or placebo and underwent scintigraphic gastric emptying (GE) and colonic filling at 6 h (CF6) of a solid-liquid meal administered 30 min postdosing. Adverse events, plasma glucose, and hormonal levels were assessed. GCSI daily diary (GCSI-DD) was completed during treatments. PK was assessed in this cohort and healthy volunteers (HVs).RESULTSAt screening, HbA1c was 7.2 ± 0.4% (SEM) and total GCSI-DD score was 1.32 ± 0.21. RM-131 accelerated GE t1/2 of solids (P = 0.011); mean difference (Δ) in solid GE t1/2 was 68.3 min (95% CI 20–117) or 66.1%. There were numerical differences in GE lag time, CF6 solids, and GE t1/2 liquids (all P < 0.14). With a significant (P < 0.014) order effect, further analysis of the first treatment period (n = 5 per group) confirmed significant RM-131 effects on GE t1/2 (solids, P = 0.016; liquids, P = 0.024; CF6, P = 0.013). PK was similar in DGE patients and HVs. There were increases in 120-min blood glucose (P = 0.07) as well as 30–90-min area under the curve (AUC) levels of growth hormone, cortisol, and prolactin (all P < 0.02) with single-dose RM-131. Only light-headedness was reported more on RM-131.CONCLUSIONSRM-131 greatly accelerates the GE of solids in patients with type 2 diabetes and documented DGE. PK is similar in diabetic patients and HVs.

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Radioisotopic assessment of gastric emptying of solids in elderly subjects

Abstract: Gastric emptying of solids is significantly delayed in elderly men; this variable must be taken into account when studies on gastric emptying rates are performed.

Cited by 33 publications

References 29 publications

Scintigraphy vs. mechanical magnetogastrography: gastric emptying analysis

Scintigraphy vs. mechanical magnetogastrography: gastric emptying analysis

Associations of age with serum insulin, proinsulin and the proinsulin-to-insulin ratio: a cross-sectional study

Randomized Controlled Phase Ib Study of Ghrelin Agonist, RM-131, in Type 2 Diabetic Women With Delayed Gastric Emptying

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