Published online Sep 21, 2013. doi: 10.3748/wjg.v19.i35.5863
Revised: May 7, 2013
Accepted: June 5, 2013
Published online: September 21, 2013
Processing time: 253 Days and 20.3 Hours
AIM: To evaluate individual components of the antro-pyloro-duodenal (APD) motor response to graded small intestinal glucose infusions in healthy humans.
METHODS: APD manometry was performed in 15 healthy subjects (12 male; 40 ± 5 years, body mass index 26.5 ± 1.6 kg/m2) during four 20-min intraduodenal infusions of glucose at 0, 0.5, 1.0 and 1.5 kcal/min, in a randomised double-blinded fashion. Glucose solutions were infused at a rate of 1 mL/min and separated by 40-min “wash-out” period. Data are mean ± SE. Inferential analyses are repeated measure analysis of variance with Bonferroni post-hoc testing.
RESULTS: At 0 kcal/min frequency of pressure waves were: antrum (7.5 ± 1.8 waves/20 min) and isolated pyloric pressure waves (IPPWs) (8.0 ± 2.3 waves/20 min) with pyloric tone (0.0 ± 0.9 mmHg). Intraduodenal glucose infusion acutely increased IPPW frequency (P < 0.001) and pyloric tone (P = 0.015), and decreased antral wave frequency (P = 0.007) in a dose-dependent fashion. A threshold for stimulation was observed at 1.0 kcal/min for pyloric phasic pressure waves (P = 0.002) and 1.5 kcal/min for pyloric tone and antral contractility.
CONCLUSION: There is hierarchy for the activation of gastrointestinal motor responses to duodenal glucose infusion. An increase in IPPWs is the first response observed.
Core tip: Antro-pyloro-duodenal manometry was performed in 15 healthy subjects. Subjects were randomly given 20 min intraduodenal infusions of glucose at 0, 0.5, 1.0 and 1.5 kcal/min. Intraduodenal glucose infusion acutely increased isolated pyloric pressure wave frequency and pyloric tone and decreased antral wave frequency in a dose-dependent fashion. A threshold for stimulation was observed at 1.0 kcal/min for pyloric phasic pressure waves and 1.5 kcal/min for pyloric tone and antral contractility. These data suggest that there is hierarchy for the activation of gastrointestinal motor responses to small intestinal glucose stimulation.