Aktuelle Ernährungsmedizin 2002; 27(6): 389-394
DOI: 10.1055/s-2002-35680
Originalarbeit
© Georg Thieme Verlag Stuttgart · New York

Die Rolle des Gastrointestinaltraktes in der Regulation der Nahrungsaufnahme beim Menschen

The Role of the GI Tract in Regulating the Food Intake in ManC.  Beglinger1
  • 1Abteilung für Gastroenterologie, Universitätsspital Basel
Manuskript nach einem Vortrag bei der gemeinsamen Jahrestagung von AKE, DGEM und GESKES Nutrition 2002 in Luzern vom 18. - 20.4.2002
Further Information

Publication History

Publication Date:
22 November 2002 (online)

Zusammenfassung

Die Regulation von Nahrungszufuhr, Nahrungsaufnahme und Verdauung ist komplex. Ein enges Zusammenspiel von verschiedenen Organfunktionen (Essen, Kauen, Schlucken; Magenentleerung, Verdauung, Absorption) muss garantiert sein. Zusätzlich müssen die verschiedenen Verdauungsfunktionen mit Appetit-, Hunger- und Sättigungsgefühlen gekoppelt werden. Die Regulation dieser integrierten Abläufe ist nicht nur hochkomplex, sondern nur unvollständig verstanden. Im vorliegenden Kapitel werden schwerpunktmäßig die gastrointestinalen Signale besprochen; zusätzlich wird deren Bedeutung im Regulationsprozess analysiert.

Abstract

Regulation of food supply, food intake and digestion is a complex procedure. It must be ensured that there is a close interaction of various organ functions (eating, chewing, swallowing; emptying of the stomach, digestion, absorption). In addition, the various digestive functions involving feelings of appetite, hunger and saturation must be linked. Regulation of these integrated procedures is not only highly complex but also incompletely understood. In the following chapter, emphasis is on the gastrointestinal signals; in addition, their importance in the process of regulation is analysed.

Literatur

  • 1 Pavlov I P. Beiträge zur Physiologie des Pankreas.  Pflügers Arch ges Physiol. 1878;  19 173-189
  • 2 Bayliss W M. Mechanisms of pancreatic secretion.  J Physiol. 1902;  28 325-353
  • 3 Feldman M, Richardson C T. Role of thought, sight, smell, and taste of food in the cephalic phase of gastric acid secretion in humans.  Gastroenterology. 1986;  90 (2) 428-433
  • 4 Blair A J, Richardson C T, Walsh J H, Feldman M. Variable contribution of gastrin to gastric acid secretion after a meal in humans.  Gastroenterology. 1987;  92 (4) 944-949
  • 5 Blair A J, Feldman M, Barnett C, Walsh J H, Richardson C T. Detailed comparison of basal and food-stimulated gastric acid secretion rates and serum gastrin concentrations in duodenal ulcer patients and normal subjects.  J Clin Invest. 1987;  79 (2) 582-587
  • 6 Feldman M, Unger R H, Walsh J H. Effect of atropine on plasma gastrin and somatostatin concentrations during sham feeding in man.  Regul Pept. 1985;  12 (4) 345-352
  • 7 Feldman M. Gastric H+ and HCO3-secretion in response to sham feeding in humans.  Am J Physiol. 1985;  248 (2 Pt 1) G 188-191
  • 8 Solomon T E. Control of exocrine pancreatic secretion. New York; Raven Press 1987
  • 9 Beltinger J, Hildebrand P, Drewe J, Christ A, Hlobil K, Ritz M. et al . Effects of spiroglumide, a gastrin receptor antagonist, on acid secretion in humans.  Eur J Clin Invest. 1999;  29 (2) 153-159
  • 10 Blair A J, Richardson C T, Vasko M, Walsh J H, Feldman M. Comparison of acid secretory responsiveness to gastrin heptadecapeptide and of gastrin heptadecapeptide pharmacokinetics in duodenal ulcer patients and normal subjects.  J Clin Invest. 1986;  78 (3) 779-783
  • 11 Adler G, Nelson D K, Katschinski M, Beglinger C. Neurohormonal control of human pancreatic exocrine secretion.  Pancreas. 1995;  10 (1) 1-13
  • 12 Adler G, Beglinger C, Braun U, Reinshagen M, Koop I, Schafmayer A. et al . Interaction of the cholinergic system and cholecystokinin in the regulation of endogenous and exogenous stimulation of pancreatic secretion in humans.  Gastroenterology. 1991;  100 (2) 537-543
  • 13 Adler G, Beglinger C. Hormones as regulators of pancreatic secretion in man.  Eur J Clin Invest. 1990;  20, Suppl 1 S 27-32
  • 14 Adler G, Beglinger C, Braun U, Reinshagen M, Koop I, Schafmayer A. Cholecystokinin is a regulator of intestinal phase-stimulated PP release.  Regul Pept. 1990;  30 (2) 105-111
  • 15 Meyer J H. Gastric emptying of ordinary food: effect of antrum on particle size.  Am J Physiol. 1980;  239 (3) G 133-135
  • 16 Mayer E A. The Physiology of Gastric Storage and Emptying. Physiology of the Gastrointestinal Tract. New York; Raven Press 1994: 929-976
  • 17 Meyer J H, Mayer E A, Jehn D, Gu Y, Fink A S, Fried M. Gastric processing and emptying of fat.  Gastroenterology. 1986;  90 (5 Pt 1) 1176-1187
  • 18 Carriere F, Renou C, Ransac S, Lopez V, De Caro J, Ferrato F. et al . Inhibition of gastrointestinal lipolysis by Orlistat during digestion of test meals in healthy volunteers.  Am J Physiol Gastrointest Liver Physiol. 2001;  281 (1) G 16-28
  • 19 Hildebrand P, Beglinger C, Gyr K, Jansen J B, Rovati L C, Zuercher M. et al . Effects of a cholecystokinin receptor antagonist on intestinal phase of pancreatic and biliary responses in man.  J Clin Invest. 1990;  85 (3) 640-664
  • 20 Liddle R A, Goldfine I D, Williams J A. Bioassay of plasma cholecystokinin in rats: effects of food, trypsin inhibitor, and alcohol.  Gastroenterology. 1984;  87 (3) 542-549
  • 21 Liddle R A, Goldfine I D, Rosen M S, Taplitz R A, Williams J A. Cholecystokinin bioactivity in human plasma. Molecular forms, responses to feeding, and relationship to gallbladder contraction.  J Clin Invest. 1985;  75 (4) 1144-1152
  • 22 Beglinger C, Fried M, Whitehouse I, Jansen J B, Lamers C B, Gyr K. Pancreatic enzyme response to a liquid meal and to hormonal stimulation. Correlation with plasma secretin and cholecystokinin levels.  J Clin Invest. 1985;  75 (5) 1471-1476
  • 23 Malagelada J R, Go V L, Summerskill W H. Altered pancreatic and biliary function after vagotomy and pyloroplasty.  Gastroenterology. 1974;  66 (1) 22-27
  • 24 MacGregor I, Parent J, Meyer J H. Gastric emptying of liquid meals and pancreatic and biliary secretion after subtotal gastrectomy or truncal vagotomy and pyloroplasty in man.  Gastroenterology. 1977;  72 (2) 195-205
  • 25 Beglinger C, Hildebrand P, Adler G, Werth B, Luo H, Delco F. et al . Postprandial control of gallbladder contraction and exocrine pancreatic secretion in man.  Eur J Clin Invest. 1992;  22 (12) 827-834
  • 26 Christ A, Werth B, Hildebrand P, Gyr K, Stalder G A, Beglinger C. Human secretin. Biologic effects and plasma kinetics in humans.  Gastroenterology. 1988;  94 (2) 311-316
  • 27 You C H, Rominger J M, Chey W Y. Effects of atropine on the action and release of secretin in humans.  Am J Physiol. 1982;  242 (6) G 608-611
  • 28 You C H, Rominger J M, Chey W Y. Potentiation effect of cholecystokinin-octapeptide on pancreatic bicarbonate secretion stimulated by a physiologic dose of secretin in humans.  Gastroenterology. 1983;  85 (1) 40-45
  • 29 Blundell J E, Lawton C L, Halford J C. Serotonin, eating behavior, and fat intake.  Obes Res. 1995;  3, Suppl 4 471-476
  • 30 Blundell J E, Green S, Burley V. Carbohydrates and human appetite.  Am J Clin Nutr. 1994;  59 (Suppl 3) 728-734
  • 31 Blundell J E, Lawton C L, Cotton J R, Macdiarmid J I. Control of human appetite: implications for the intake of dietary fat.  Annu Rev Nutr. 1996;  16 285-319
  • 32 Woods S C, Seeley R J, Porte D, Schwartz M W. Signals that regulate food intake and energy homeostasis.  Science. 1998;  280 (5368) 1378-1383
  • 33 Woods S C, Schwartz M W, Baskin D G, Seeley R J. Food intake and the regulation of body weight.  Annu Rev Psychol. 2000;  51 255-277
  • 34 Smith G P. Introduction to the reviews on peptides and the control of food intake and body weight.  Neuropeptides. 1999;  33 (5) 323-328
  • 35 Smith G P. The direct and indirect controls of meal size.  Neurosci Biobehav Rev. 1996;  20 (1) 41-46
  • 36 Schwartz M W, Woods S C, Porte D, Seeley R J, Baskin D G. Central nervous system control of food intake.  Nature. 2000;  404 (6778) 661-671
  • 37 Smith G P, Gibbs J. Gut peptides and postprandial satiety.  Fed Proc. 1984;  43 (14) 2889-2892
  • 38 Smith G P, Gibbs J. Cholecystokinin: a putative satiety signal.  Pharmacol Biochem Behav. 1975;  3 (Suppl 1) 135-138
  • 39 Drewe J, Gadient A, Rovati L C, Beglinger C. Role of circulating cholecystokinin in control of fat-induced inhibition of food intake in humans (see comments).  Gastroenterology. 1992;  102 (5) 1654-1659
  • 40 Gutzwiller J P, Drewe J, Goke B, Schmidt H, Rohrer B, Lareida J. et al . Glucagon-like peptide-1 promotes satiety and reduces food intake in patients with diabetes mellitus type 2.  Am J Physiol. 1999;  276 (5 Pt 2) R 1541-1544
  • 41 Gutzwiller J P, Goke B, Drewe J, Hildebrand P, Ketterer S, Handschin D. et al . Glucagon-like peptide-1: a potent regulator of food intake in humans.  Gut. 1999;  44 (1) 81-86
  • 42 Gutzwiller J P, Drewe J, Ketterer S, Hildebrand P, Krautheim A, Beglinger C. Interaction between CCK and a preload on reduction of food intake is mediated by CCK-A receptors in humans.  Am J Physiol Regul Integr Comp Physiol. 2000;  279 (1) R 189-195
  • 43 Verdich C, Flint A, Gutzwiller J P, Naslund E, Beglinger C, Hellstrom P M. et al . A meta-analysis of the effect of glucagon-like peptide-1 (7 - 36) amide on ad libitum energy intake in humans.  J Clin Endocrinol Metab. 2001;  86 (9) 4382-4389
  • 44 French S J, Murray B, Rumsey R D, Fadzlin R, Read N W. Adaptation to high-fat diets: effects on eating behaviour and plasma cholecystokinin.  Br J Nutr. 1995;  73 (2) 179-189
  • 45 French S J, Conlon C A, Mutuma S T, Arnold M, Read N W, Meijer G. et al . The effects of intestinal infusion of long-chain fatty acids on food intake in humans.  Gastroenterology. 2000;  119 (4) 943-948
  • 46 Welch I, Saunders K, Read N W. Effect of ileal and intravenous infusions of fat emulsions on feeding and satiety in human volunteers.  Gastroenterology. 1985;  89 (6) 1293-1297
  • 47 Welch I M, Baxter A J, Read N W. Effect of naloxone, domperidone and idazoxan on the delay in gastric emptying induced by ileal lipid.  Aliment Pharmacol Ther. 1987;  1 (5) 425-431
  • 48 Welch I M, Cunningham K M, Read N W. Regulation of gastric emptying by ileal nutrients in humans.  Gastroenterology. 1988;  94 (2) 401-404
  • 49 Welch I M, Sepple C P, Read N W. Comparisons of the effects on satiety and eating behaviour of infusion of lipid into the different regions of the small intestine.  Gut. 1988;  29 (3) 306-311
  • 50 Gutzwiller J P, Drewe J, Ketterer S, Hildebrand P, Krautheim A, Beglinger C. Interaction between CCK and a preload on reduction of food intake is mediated by CCK-A receptors in humans.  Am J Physiol Regul Integr Comp Physiol. 2000;  279 (1) R 189-195
  • 51 Liddle R A, Gertz B J, Kanayama S, Beccaria L, Coker L D, Turnbull T A. et al . Effects of a novel cholecystokinin (CCK) receptor antagonist, MK-329, on gallbladder contraction and gastric emptying in humans. Implications for the physiology of CCK.  J Clin Invest. 1989;  84 (4) 1220-1225
  • 52 Nauck M A, Weber I, Bach I, Richter S, Orskov C, Holst J J. et al . Normalization of fasting glycaemia by intravenous GLP-1 ([7 - 36 amide] or [7 - 37]) in type 2 diabetic patients (In Process Citation).  Diabet Med. 1998;  15 (11) 937-945
  • 53 Nauck M A, Niedereichholz U, Ettler R, Holst J J, Orskov C, Ritzel R. et al . Glucagon-like peptide 1 inhibition of gastric emptying outweighs its insulinotropic effects in healthy humans.  Am J Physiol. 1997;  273 (5 Pt 1) E 981-988
  • 54 Feinle C, D'Amato M, Read N W. Cholecystokinin-A receptors modulate gastric sensory and motor responses to gastric distension and duodenal lipid.  Gastroenterology. 1996;  110 (5) 1379-1385
  • 55 Matzinger D, Degen L, Drewe J, Meuli J, Duebendorfer R, Ruckstuhl N. et al . The role of long chain fatty acids in regulating food intake and cholecystokinin release in humans.  Gut. 2000;  46 (5) 688-693
  • 56 Matzinger D, Gutzwiller J P, Drewe J, Orban A, Engel R, D'Amato M. et al . Inhibition of food intake in response to intestinal lipid is mediated by cholecystokinin in humans.  Am J Physiol. 1999;  277 (6 Pt 2) R 1718-1724
  • 57 Turton M D, O'Shea D, Gunn I, Beak S A, Edwards C M, Meeran K. et al . A role for glucagon-like peptide-1 in the central regulation of feeding (see comments).  Nature. 1996;  379 (6560) 69-72
  • 58 Kopin A S, Mathes W F, McBride E W, Nguyen M, Al-Haider W, Schmitz F. et al . The cholecystokinin-A receptor mediates inhibition of food intake yet is not essential for the maintenance of body weight (published erratum appears in J Clin Invest 1999 Mar; 103 [5]: 759).  J Clin Invest. 1999;  103 (3) 383-391
  • 59 Schwartz G J, Whitney A, Skoglund C, Castonguay T W, Moran T H. Decreased responsiveness to dietary fat in Otsuka Long-Evans Tokushima fatty rats lacking CCK-A receptors.  Am J Physiol. 1999;  277 (4 Pt 2) R 1144-1151
  • 60 Bado A, Durieux C, Moizo L, Roques B P, Lewin M J. Cholecystokinin-A receptor mediation of food intake in cats.  Am J Physiol. 1991;  260 (4 Pt 2) R 693-697
  • 61 Bado A, Levasseur S, Attoub S, Kermorgant S, Laigneau J P, Bortoluzzi M N. et al . The stomach is a source of leptin.  Nature. 1998;  394 (6695) 790-793
  • 62 Bado A, Rodriguez M, Lewin M J, Martinez J, Dubrasquet M. Cholecystokinin suppresses food intake in cats: structure-activity characterization.  Pharmacol Biochem Behav. 1988;  31 (2) 297-303
  • 63 Byrne M M, Goke B. Human studies with glucagon-like-peptide-1: potential of the gut hormone for clinical use.  Diabet Med. 1996;  13 (10) 854-860
  • 64 Flint A, Raben A, Astrup A, Holst J J. Glucagon-like Peptide 1 Promotes Satiety and Suppresses Energy Intake in Humans.  J Clin Invest. 1998;  101 (3) 515-520
  • 65 Flint A, Raben A, Rehfeld J F, Holst J J, Astrup A. The effect of glucagon-like peptide-1 on energy expenditure and substrate metabolism in humans.  Int J Obes Relat Metab Disord. 2000;  24 (3) 288-298
  • 66 Andrews J M, Doran S, Hebbard G S, Rassias G, Sun W M, Horowitz M. Effect of glucose supplementation on appetite and the pyloric motor response to intraduodenal glucose and lipid.  Am J Physiol. 1998;  274 (4 Pt 1) G 645-652
  • 67 Andrews J M, Rayner C K, Doran S, Hebbard G S, Horowitz M. Physiological changes in blood glucose affect appetite and pyloric motility during intraduodenal lipid infusion.  Am J Physiol. 1998;  275 (4 Pt 1) G 797-804

Prof. Dr. C. Beglinger

Abteilung für Gastroenterologie · Universitätsspital

4031 Basel · Schweiz