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1 University of Adelaide Department of Medicine, Royal Adelaide Hospital, Adelaide, South Australia 5000, Australia; and 2 Department of Internal Medicine, College of Medicine, Konkuk University, Seoul, Korea
Recent studies suggest that the
interaction between small intestinal nutrient stimulation and the blood
glucose concentration is important in the regulation of gastric
motility and appetite. The purpose of this study was to determine
whether the effects of cholecystokinin octapeptide (CCK-8) on
antropyloric motility and appetite are influenced by changes in the
blood glucose concentration within the normal postprandial
range. Seven healthy volunteers were studied on 4 separate
days. A catheter incorporating a sleeve sensor was positioned across
the pylorus, and the blood glucose was stabilized at either 4 mmol/l (2 days) or 8 mmol/l (2 days). After the desired blood glucose had been
maintained for 90 min, an intravenous infusion of either CCK-8 (2 ng · kg
1 · min
1)
or saline (control) was given for 60 min. Thirty minutes after the
infusion began, the catheter was removed and subjects drank 400 ml of
water with guar gum before being offered a buffet meal. The amount of
food consumed (kcal) was quantified. The order of the studies was
randomized and single-blinded. There were fewer antral waves at a blood
glucose of 8 than at 4 mmol/l during the 90-min period before the
infusions (P < 0.05) and during the first 30 min of CCK-8 or
saline infusion (P = 0.07). CCK-8 suppressed antral waves
(P < 0.05), stimulated isolated pyloric pressure waves
(IPPWs) (P < 0.01), and increased basal pyloric pressure (P < 0.005) compared with control. During administration of
CCK-8, basal pyloric pressure (P < 0.01), but not the number
of IPPWs, was greater at a blood glucose of 8 mmol/l than at 4 mmol/l.
CCK-8 suppressed the energy intake at the buffet meal (P < 0.01), with no significant difference between the two blood glucose
concentrations. We conclude that the acute effect of exogenous CCK-8 on
basal pyloric pressure, but not appetite, is modulated by physiological changes in the blood glucose concentration.
manometry; hyperglycemia; food intake; hunger
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