Centrally administered glucagon-like peptide-1 (GLP-1) inhibits feeding in fasted rats, but its role in human satiety has been largely unexplored. The present study investigated the effect of peripheral GLP-1 infusion on gastric emptying and satiety in man. Ten non-obese male subjects were infused in a randomized single-blind within-subject crossover study using saline infusion as control. They received either a GLP-1 infusion (1·2 pmol/kg per min) or a saline infusion for 1 h, at 18.00 hours. At 20 min after starting the infusion the gastric emptying of a 400 ml water load was measured. Subjects completed behavioural self-rating scales to assess hunger and satiety. After 40 min subjects were given a buffet meal ad libitum and their food intake was recorded. GLP-1 infusion raised circulating GLP-1 concentrations to approximately twice those seen following a meal. It did not affect circulating insulin levels but caused a small fall in glucose levels. Gastric emptying of the water load was significantly delayed by the GLP-1 infusion. Energy intake from the buffet was unaffected by GLP-1 infusion. Self-assessment of hunger and satiety was similarly unaffected by the infusion before the buffet meal, although subjects tended to be less hungry after the buffet meal following GLP-1 infusion (P < 0·09). GLP-1 infusion delayed gastric emptying but had a minimal effect on food intake and satiety. This study casts doubts on whether GLP-1 is a major satiety factor in man, although a raised circulating plasma glucose level, as would normally occur postprandially, might be necessary for GLP-1 to increase satiety.
Measurement of the electrical impedance of the gastric region is carried out with the epigastrograph. This generates and applies alternating current around the abdominal area and measures the potential difference in order to determine the impedance externally, via electrodes. The change of epigastric impedance for a subject, given a meal after fasting, depends on the conductivity of the meal compared to the stomach and surrounding tissues. Typically a conductive meal has conductivity >7 mS cm(-1), non-conductive <2 mS cm(-1) and neutral about 4.5 mS cm(-1). Half-emptying times (T50s) from gastric emptying studies in volunteers using three test meals of 450 ml volume were obtained and found to be shorter than expected from the literature. The meals were a 10% glucose solution and two milk shakes of energy 1,300 kJ and 2,850 kJ, respectively. These electrical impedance epigastrography (EIE) measurements were carried out with scintigraphy. The T50 values of the latter were significantly longer. The direct comparison of the normalized experimental data obtained by both methods led to the concept that EIE measurements are mainly influenced by gastric secretion. Thus the EIE trace of a 'neutral' meal suggests the hypothesis that the volume of the meal is not the significant factor but is influenced by gastric acid secretions. Physiology of the gastric mucosa during the digestion of a meal and intragastric pH values also suggests this. Gastric function studies using EIE measurements may therefore reflect gastric ionic concentration rather than the volume of the contents of the stomach. In turn this could lead to the development of a non-invasive method for the continuous recording of gastric acid secretions.
Scintigraphy has been used to study gastric emptying in normal subjects when fed simple and complex meals as part of a larger project where electrical impedance epigastrography has also been used simultaneously with a conventional scintigraphic technique.In this paper, the results of the scintigraphic data analysis for emptying times of the fundus, body, and antrum, as well as the whole stomach are presented since variations have been found in the half-emptying values depending on the region of the stomach selected.When a meal enters the stomach, mixing waves begin. These waves macerate the meal with gentle, rippling, peristaltic movements, mixing it with secretions of the gastric glands. Few mixing waves are observed in the fundus, which primarily functions as a storage compartment. More vigorous mixing waves begin at the body part and persist for a few minutes before intensifying as they reach the antrum.We propose that scintigraphic measurements of gastric emptying using the triregional pattern can be sensitive in quantifying emptying of simple and complex liquids and the method has the ability to measure the emptying rates of the different parts of the stomach for these meals. Observed relationships between scintigraphic measurements of the various parts of the stomach and gastric emptying indicate that in all types of meals, the body region represents well the overall emptying time of the whole stomach. Whereas in the antral region, the emptying time is longer for the simple meals and relatively shorter for the complex ones.
Electrical impedance measurements have been used by scientists since the 1980s to investigate the gastric function. In this work, these measurements were carried out using the epigastrograph, a device generating alternating current of 32 kHz and injecting it in the gastric area of the human body with surface electrodes, located around the abdominal area. Although the method has been used for about three decades the physiological interpretation of these measurements is still under research. This work states that the electrical impedance measurements from the gastric area depend on the conductivity of the gastric lumen, due mainly to gastric acid secretions and to the conductivity and chemical form of the ingested meal. By choosing the proper test meal the gastric acidity in the empty, healthy stomach was also estimated. The estimated value is in accordance with the literature. The method is non-invasive, relatively inexpensive, simple to medical technologists and subjects, and involves no radiation risk. The method may form the basis for the development of a non-invasive gastric pH meter.
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