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. 1996 Jan;38(1):23–27. doi: 10.1136/gut.38.1.23

Relation between gastric emptying rate and rate of intraluminal lipolysis.

B D Maes 1, Y F Ghoos 1, B J Geypens 1, M I Hiele 1, P J Rutgeerts 1
PMCID: PMC1382974  PMID: 8566854

Abstract

The variable gastric emptying rate of a test meal is one of the major problems in evaluating accurately gastrointestinal physiological functions beyond the stomach. The aim of this study was to evaluate the effect of the gastric emptying rate on the rate of intraluminal lipolysis. Thirty four subjects without pancreatic disease (21 with a normal gastric emptying and 13 with a known slow gastric emptying) and 14 subjects with pancreatic disease (four without and 10 with pancreatic insufficiency) were studied using a dual labelled breath test. The test meal consisted of one egg, 60 grams of white bread, 10 grams of margarine, and 150 ml of water (350 kcal). The egg yolk was labelled with 91 mg of 13C-octanoic acid, the margarine was labelled with 296 kBq of distearyl-2-14C-octanoyl-glycerol. Breath samples were taken every 15 minutes during six hours and analysed for 13CO2 and 14CO2 content. The gastric emptying rate of the meal was evaluated by the gastric emptying coefficient, the half emptying time, and the lag phase; the rate of intraluminal lipolysis was evaluated by the six hours cumulative 14CO2 excretion. Despite a clear distinction in the rate of intraluminal lipolysis, no difference could be detected in gastric emptying rate of the test meal between subjects without and with pancreatic disease. In subjects with pancreatic insufficiency, intraluminal hydrolysis was the rate limiting process in fat assimilation; in patients without pancreatic insufficiency, however, gastric emptying could be rate limiting. Therefore, patients with known slow gastric emptying, displayed a significantly decreased rate of intraluminal lipolysis compared with normal controls. This decrease could be corrected for accurately using a correction factor based on the gastric emptying coefficient. In conclusion, the combined 13C-octanoic acid and 14C-mixed triglyceride breath test permits the measurement of gastric emptying rate and intraluminal lipolysis simultaneously in a minimally invasive way. Correction of intraluminal lipolysis rate for gastric emptying rate of the given test meal permits evaluation of fat assimilation rates in a physiological way regardless of gastric emptying disorders.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Carey M. C., Small D. M., Bliss C. M. Lipid digestion and absorption. Annu Rev Physiol. 1983;45:651–677. doi: 10.1146/annurev.ph.45.030183.003251. [DOI] [PubMed] [Google Scholar]
  2. Cortot A., Phillips S. F., Malagelada J. R. Gastric emptying of lipids after ingestion of a solid-liquid meal in humans. Gastroenterology. 1981 May;80(5 Pt 1):922–927. [PubMed] [Google Scholar]
  3. DeNigris S. J., Hamosh M., Kasbekar D. K., Fink C. S., Lee T. C., Hamosh P. Secretion of human gastric lipase from dispersed gastric glands. Biochim Biophys Acta. 1985 Aug 22;836(1):67–72. doi: 10.1016/0005-2760(85)90221-8. [DOI] [PubMed] [Google Scholar]
  4. Edelbroek M., Horowitz M., Maddox A., Bellen J. Gastric emptying and intragastric distribution of oil in the presence of a liquid or a solid meal. J Nucl Med. 1992 Jul;33(7):1283–1290. [PubMed] [Google Scholar]
  5. Fredrikzon B., Bläckberg L. Lingual lipase: an important lipase in the digestion of dietary lipids in cystic fibrosis? Pediatr Res. 1980 Dec;14(12):1387–1390. doi: 10.1203/00006450-198012000-00026. [DOI] [PubMed] [Google Scholar]
  6. Ghoos Y. F., Maes B. D., Geypens B. J., Mys G., Hiele M. I., Rutgeerts P. J., Vantrappen G. Measurement of gastric emptying rate of solids by means of a carbon-labeled octanoic acid breath test. Gastroenterology. 1993 Jun;104(6):1640–1647. doi: 10.1016/0016-5085(93)90640-x. [DOI] [PubMed] [Google Scholar]
  7. Haycock G. B., Schwartz G. J., Wisotsky D. H. Geometric method for measuring body surface area: a height-weight formula validated in infants, children, and adults. J Pediatr. 1978 Jul;93(1):62–66. doi: 10.1016/s0022-3476(78)80601-5. [DOI] [PubMed] [Google Scholar]
  8. Kesteloot H., Geboers J., Pietinen P. On the within-population relationship between dietary habits and serum lipid levels in Belgium. Eur Heart J. 1987 Aug;8(8):821–831. doi: 10.1093/oxfordjournals.eurheartj.a062345. [DOI] [PubMed] [Google Scholar]
  9. Liao T. H., Hamosh P., Hamosh M. Fat digestion by lingual lipase: mechanism of lipolysis in the stomach and upper small intestine. Pediatr Res. 1984 May;18(5):402–409. doi: 10.1203/00006450-198405000-00002. [DOI] [PubMed] [Google Scholar]
  10. Long W. B., Weiss J. B. Rapid gastric emptying of fatty meals in pancreatic insufficiency. Gastroenterology. 1974 Nov;67(5):920–925. [PubMed] [Google Scholar]
  11. Meyer J. H., Mayer E. A., Jehn D., Gu Y., Fink A. S., Fried M. Gastric processing and emptying of fat. Gastroenterology. 1986 May;90(5 Pt 1):1176–1187. doi: 10.1016/0016-5085(86)90383-5. [DOI] [PubMed] [Google Scholar]
  12. Moreau H., Gargouri Y., Lecat D., Junien J. L., Verger R. Screening of preduodenal lipases in several mammals. Biochim Biophys Acta. 1988 Apr 15;959(3):247–252. doi: 10.1016/0005-2760(88)90197-x. [DOI] [PubMed] [Google Scholar]
  13. Moreau H., Laugier R., Gargouri Y., Ferrato F., Verger R. Human preduodenal lipase is entirely of gastric fundic origin. Gastroenterology. 1988 Nov;95(5):1221–1226. doi: 10.1016/0016-5085(88)90354-x. [DOI] [PubMed] [Google Scholar]
  14. Patton J. S., Rigler M. W., Liao T. H., Hamosh P., Hamosh M. Hydrolysis of triacylglycerol emulsions by lingual lipase. A microscopic study. Biochim Biophys Acta. 1982 Aug 18;712(2):400–407. doi: 10.1016/0005-2760(82)90359-9. [DOI] [PubMed] [Google Scholar]
  15. Porter H. P., Saunders D. R., Tytgat G., Brunser O., Rubin C. E. Fat absorption in bile fistula man. A morphological and biochemical study. Gastroenterology. 1971 Jun;60(6):1008–1019. [PubMed] [Google Scholar]
  16. Rigler M. W., Honkanen R. E., Patton J. S. Visualization by freeze fracture, in vitro and in vivo, of the products of fat digestion. J Lipid Res. 1986 Aug;27(8):836–857. [PubMed] [Google Scholar]
  17. Vantrappen G. R., Rutgeerts P. J., Ghoos Y. F., Hiele M. I. Mixed triglyceride breath test: a noninvasive test of pancreatic lipase activity in the duodenum. Gastroenterology. 1989 Apr;96(4):1126–1134. doi: 10.1016/0016-5085(89)91632-6. [DOI] [PubMed] [Google Scholar]
  18. Wollaeger E. E. Editorial: Fat, feces, and the importance of the ileum. Mayo Clin Proc. 1973 Dec;48(12):833–835. [PubMed] [Google Scholar]

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