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1 Medicine, Royal Adelaide Hospital, University of Adelaide, Adelaide, South Australia, Australia
2 Medizinische Klinik, University of Munich, Munich, Germany
* To whom correspondence should be addressed. E-mail: christine.feinle{at}adelaide.edu.au.
Enterally administered lipid modulates antropyloroduodenal motility, gut hormone release, appetite and energy intake. We hypothesized that these effects would be dependent on both the load, and duration, of small intestinal exposure to lipid. 11 healthy men were studied on four occasions in double-blind, randomized, fashion. Antropyloroduodenal motility, plasma cholecystokinin (CCK) and peptide YY (PYY) concentrations and appetite perceptions were measured during intraduodenal infusion of lipid (Intralipid®) at (i) 1.33 kcal/min for 50 min,(ii) 4 kcal/min for 50 min and (iii) 1.33 kcal/min for 150 min, or (iv) saline for 150 min. Immediately after the infusions energy intake was quantified. Pressure wave sequences (PWSs) were suppressed, and basal pyloric pressure, isolated pyloric pressure waves (IPPWs), plasma CCK and PYY stimulated (all P<0.05), during the first 50 min of lipid infusion, in a load-dependent fashion. The effect of the 4 kcal/min infusion was sustained so that the suppression of antral pressure waves (PWs) and PWSs and increase in PYY remained evident after cessation of the infusion (all P<0.05). The prolonged lipid infusion (1.33 kcal/min for 150 min) suppressed antral PWs, stimulated CCK and PYY and basal pyloric pressure (all P<0.05) and tended to stimulate IPPWs when compared with saline throughout the entire infusion period. There was no significant effect of any of the lipid infusions on appetite or energy intake, although nausea was slightly higher (P<0.05) with the 4 kcal/min infusion. In conclusion, both the load, and duration, of small intestinal lipid influence antropyloroduodenal motility and patterns of CCK and PYY release.
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