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Role of lipase in the regulation of postprandial gastric acid secretion and emptying of fat in humans: a study with orlistat a highly specific lipase inhibitor

机译:脂肪酶在调节人餐后胃酸分泌和脂肪排空中的作用:一项高度特异性的脂肪酶抑制剂奥利司他的研究

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摘要

BACKGROUND AND AIMS—To investigate the importance of lipase on gastric functions, we studied the effects of orlistat, a potent and specific inhibitor of lipase, on postprandial gastric acidity and gastric emptying of fat.
METHODS—Fourteen healthy volunteers participated in a double blind, placebo controlled, randomised study. In a two way cross over study with two test periods of five days, separated by at least 14 days, orlistat 120 mg three times daily or placebo was given with standardised daily meals. In previous experiments we found that this dose almost completely inhibited postprandial duodenal lipase activity. Subjects underwent 28 hour intragastric pH-metry on day 4, and a gastric emptying study with a mixed meal (800 kcal) labelled with 999mTc sulphur colloid (solids) and 111Inthiocyanate (fat) on day 5. Gastric pH data were analysed for three postprandial hours and the interdigestive periods.
RESULTS—Orlistat inhibited almost completely (by 75%) lipase activity and accelerated gastric emptying of both the solid (by 52%) and fat (by 44%) phases of the mixed meal (p<0.03). Orlistat increased postprandial gastric acidity (from a median pH of 3.3 to 2.7; p<0.01). Postprandial cholecystokinin release was lower with orlistat (p<0.03).
CONCLUSION—Lipase has an important role in the regulation of postprandial gastric acid secretion and fat emptying in humans. These effects might be explained by lipolysis induced release of cholecystokinin.


>Keywords: lipase; orlistat; gastric secretion; gastric emptying; pH-metry
机译:背景与目的—为研究脂肪酶对胃功能的重要性,我们研究了一种有效的脂肪酶特异性抑制剂奥利司他对餐后胃酸度和胃中脂肪排空的影响。
方法— 14名健康志愿者参加一项双盲,安慰剂对照的随机研究。以两种方式进行的交叉研究,两个试验期为期五天,至少相隔14天,每天服用奥利司他120 mg三次,或安慰剂接受每日标准饮食。在以前的实验中,我们发现该剂量几乎完全抑制了餐后十二指肠脂肪酶的活性。受试者在第4天接受了28小时的胃内pH测定,并进行了胃排空研究,其中混合餐(800 kcal)标有 999m Tc硫胶体(固体),< sup> 111In 硫氰酸盐(脂肪),第5天。分析了餐后三个小时和消化期间的胃pH值数据。混合粉的固相(52%)和脂肪(44%)的比例(p <0.03)。奥利司他增加餐后胃酸度(从中值pH 3.3到2.7; p <0.01)。奥利司他使餐后胆囊收缩素释放降低(p <0.03)。
结论—脂肪酶在调节人餐后胃酸分泌和脂肪排空中具有重要作用。这些作用可能是由脂解诱导的胆囊收缩素释放所致。


>关键词:脂肪酶;奥利司他胃分泌物胃排空pH测定

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