Gastroenterology

Gastroenterology

Volume 131, Issue 6, December 2006, Pages 1717-1724
Gastroenterology

Clinical–alimentary tract
Gastric Sensorimotor Functions and Hormone Profile in Normal Weight, Overweight, and Obese People

https://doi.org/10.1053/j.gastro.2006.10.025Get rights and content

Background & Aims: Peptide YY (PYY) levels are reported to be decreased in obesity. The relation between gastric functions, satiation, and gut hormones in obesity is incompletely understood. The aim of this study was to compare gastric volumes, emptying, maximum tolerated volumes, postchallenge symptoms, and selected gut hormones in normal, overweight, or obese healthy volunteers. Methods: In 73 nonbulimic normal, overweight, or obese participants weighing less than 137 kg, we measured gastric emptying of solids and liquids by scintigraphy (gastric emptying half-time [GE t1/2]); gastric volumes by single-photon emission computed tomography; maximum tolerated volumes and symptoms by satiation test; and plasma leptin, ghrelin, insulin, glucagon-like peptide 1, and PYY levels. Groups were compared using 1-way analysis of covariance adjusted for sex. Univariate associations among measured responses were assessed using Spearman correlations. Multiple linear regression models, adjusting for weight and sex, assessed the independent ability of gastric functions and hormones to predict satiation volume. Results: Obese and overweight subjects had significantly lower postprandial gastric volumes, higher fasting and postprandial insulin and leptin levels, and lower fasting ghrelin and lower postprandial reduction in ghrelin levels. PYY levels were not different in obese or overweight subjects compared with controls. The GE t1/2 was correlated inversely with postprandial PYY; increased body weight was associated with faster GE t1/2 of solids (rs = 0.33, P = .005) and liquids (rs = 0.24, P = .04). Postprandial changes in gastric volume and PYY were independent predictors of satiation (both P = .01). Conclusions: Overweight or obesity are associated with lower postprandial gastric volumes and normal PYY levels. Gastric emptying influences postprandial PYY levels. Postprandial PYY and gastric volume independently predict satiation volume in nonbulimic people across a wide body mass index range.

Section snippets

Participants

Seventy-three healthy volunteers of normal weight (body mass index [BMI], 18–24.9 kg/m2), overweight (BMI, 25–29.9 kg/m2), and obese (BMI, >30 kg/m2) categories were recruited. They were contacted either by letter from a database of residents from Olmsted County, Minnesota who previously had replied to a questionnaire mailing or by public advertisement.

Men and women between the ages of 18 and 65 years residing in Olmsted County, Minnesota who were not currently on treatment for cardiac,

Participant Demographics

Seventy-three subjects were recruited from January 2005 to December 2005. One subject in the normal weight group had a vasovagal reaction to needles and could not complete the study and is not included in the analyses. None of the participants had features suggestive of bulimia. Table 1 summarizes the baseline characteristics (mean ± SEM) for the normal, overweight, and obese participants. No associations with age, sex, and race with BMI group status were detected.

Anthropometrics

As expected from the design of

Discussion

Our study addressed 2 aims: first, to compare gastric motor and sensory functions and hormonal responses in 3 BMI groups ranging from normal weight to obesity; and second, to evaluate the relationship between these gastric and hormonal factors in response to feeding across a broad range of body mass.

First, this study has shown that there were similar rates of gastric emptying of solids, MTV, and postchallenge symptoms in the 3 body mass groups corresponding to normal weight, overweight, and

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    Supported by General Clinical Research Center grant (M01-RR00585; patient care, gastrointestinal, and immunochemistry cores) from the National Institutes of Health and by grants R01 DK67071 and K24 DK02638 to Dr Camilleri from the National Institutes of Health.

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