Brief Article
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World J Gastroenterol. Sep 21, 2013; 19(35): 5863-5869
Published online Sep 21, 2013. doi: 10.3748/wjg.v19.i35.5863
Modulation of individual components of gastric motor response to duodenal glucose
Adam M Deane, Laura K Besanko, Carly M Burgstad, Marianne J Chapman, Michael Horowitz, Robert JL Fraser
Adam M Deane, Marianne J Chapman, Discipline of Acute Care Medicine, University of Adelaide, Adelaide 5000, South Australia, Australia
Adam M Deane, Marianne J Chapman, Intensive Care Unit, Royal Adelaide Hospital, Adelaide 5000, South Australia, Australia
Adam M Deane, Marianne J Chapman, Michael Horowitz, Robert JL Fraser, National Health and Medical Research Council of Australia Centre for Clinical Research Excellence in Nutritional Physiology and Outcomes, Adelaide 5000, South Australia, Australia
Laura K Besanko, Robert JL Fraser, Investigation and Procedures Unit, Repatriation General Hospital, Daw Park 5041, South Australia, Australia
Carly M Burgstad, Department of Gastroenterology and Hepatology, Royal Adelaide Hospital, Adelaide 5000, South Australia, Australia
Michael Horowitz, Robert JL Fraser, Discipline of Medicine, University of Adelaide, Royal Adelaide Hospital, Adelaide 5000, South Australia, Australia
Author contributions: Deane AM, Horowitz M, Fraser RJL and Chapman MJ made substantial contributions to the design of the study; Deane AM, Besanko LK and Burgstad CM made substantial contribution to acquisition of data, analysis and interpretation of data; Deane AM, Besanko LK, Fraser RJL and Burgstad CM drafted the article; Deane AM, Besanko LK, Chapman MJ, Horowitz M, Fraser RJL and Burgstad CM approved the final version of the manuscript to be published; Chapman MJ, Horowitz M and Fraser RJL reviewed the article for critically important intellectual content.
Supported by A project grant from the Royal Adelaide Hospital
Correspondence to: Dr. Adam M Deane, Intensive Care Unit, Level 4, Emergency Services Building, Royal Adelaide Hospital, North Terrace, Adelaide 5000, South Australia, Australia. adam.deane@adelaide.edu.au
Telephone: +61-8-82222818 Fax: +61-8-82222367
Received: January 10, 2013
Revised: May 7, 2013
Accepted: June 5, 2013
Published online: September 21, 2013
Processing time: 253 Days and 20.3 Hours
Abstract

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.

Keywords: Glucose; Gastrointestinal motility; Pyloric; Antral; Duodenum; Manometry; Motor activity; Blood glucose

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.