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      Relationship of gastric emptying or accommodation with satiation, satiety, and postprandial symptoms in health

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          Abstract

          <p class="first" id="d1718452e233">A higher volume to comfortable fullness postprandially correlated with a higher calorie intake at ad libitum buffet meal. Gastric emptying of solids is correlated to satiation (volume to fullness and maximum tolerated volume) and satiety (the calorie intake at buffet meal) and symptoms of nausea, pain, and aggregate symptom score after a fully satiating meal. There was no significant correlation between gastric accommodation and either satiation or satiety indices, postprandial symptoms, or gastric emptying. </p><p class="first" id="d1718452e236">The contributions of gastric emptying (GE) and gastric accommodation (GA) to satiation, satiety, and postprandial symptoms remain unclear. We aimed to evaluate the relationships between GA or GE with satiation, satiety, and postprandial symptoms in healthy overweight or obese volunteers (total <i>n</i> = 285, 73% women, mean BMI 33.5 kg/m <sup>2</sup>): 26 prospectively studied obese, otherwise healthy participants and 259 healthy subjects with previous similar GI testing. We assessed GE of solids, gastric volumes, calorie intake at buffet meal, and satiation by measuring volume to comfortable fullness (VTF) and maximum tolerated volume (MTV) by using Ensure nutrient drink test (30 ml/min) and symptoms 30 min after MTV. Relationships between GE or GA with satiety, satiation, and symptoms were analyzed using Spearman rank ( <i>r <sub>s</sub> </i>) and Pearson ( <i>R</i>) linear correlation coefficients. We found a higher VTF during satiation test correlated with a higher calorie intake at ad libitum buffet meal ( <i>r <sub>s</sub> </i> = 0.535, <i>P</i> &lt; 0.001). There was a significant inverse correlation between gastric half-emptying time (GE <i>T</i> <sub>1/2</sub>) and VTF ( <i>r <sub>s</sub> </i> = −0.317, <i>P</i> &lt; 0.001) and the calorie intake at buffet meal ( <i>r <sub>s</sub> </i> = −0.329, <i>P</i> &lt; 0.001), and an inverse correlation between GE Tlag and GE25% emptied with VTF ( <i>r <sub>s</sub> </i> = −0.273, <i>P</i> &lt; 0.001 and <i>r <sub>s</sub> </i> = −0.248, <i>P</i> &lt; 0.001, respectively). GE <i>T</i> <sub>1/2</sub> was significantly associated with satiation (MTV, <i>R = −</i>0.234, <i>P</i> &lt; 0.0001), nausea ( <i>R = </i>0.145, <i>P</i> = 0.023), pain ( <i>R = </i>0.149, <i>P</i> = 0.012), and higher aggregate symptom score ( <i>R = </i>0.132, <i>P</i> = 0.026). There was no significant correlation between GA and satiation, satiety, postprandial symptoms, or GE. We concluded that GE of solids, rather than GA, is associated with postprandial symptoms, satiation, and satiety in healthy participants. </p><p id="d1718452e338"> <b>NEW &amp; NOTEWORTHY</b> A higher volume to comfortable fullness postprandially correlated with a higher calorie intake at ad libitum buffet meal. Gastric emptying of solids is correlated to satiation (volume to fullness and maximum tolerated volume) and satiety (the calorie intake at buffet meal) and symptoms of nausea, pain, and aggregate symptom score after a fully satiating meal. There was no significant correlation between gastric accommodation and either satiation or satiety indices, postprandial symptoms, or gastric emptying. </p>

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          Most cited references21

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          3 years of liraglutide versus placebo for type 2 diabetes risk reduction and weight management in individuals with prediabetes: a randomised, double-blind trial

          Liraglutide 3·0 mg was shown to reduce bodyweight and improve glucose metabolism after the 56-week period of this trial, one of four trials in the SCALE programme. In the 3-year assessment of the SCALE Obesity and Prediabetes trial we aimed to evaluate the proportion of individuals with prediabetes who were diagnosed with type 2 diabetes.
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            Symptoms associated with impaired gastric emptying of solids and liquids in functional dyspepsia.

            The relationship between functional dyspepsia and delayed gastric emptying of solids or liquids is still unclear. The aim of the present study was to investigate in dyspeptic patients the prevalence of delayed gastric emptying for solids or for liquids and to investigate the relationship to the dyspepsia symptom pattern. In 392 and 330 patients with functional dyspepsia, the solid and liquid gastric emptying, respectively, was measured using breath tests, and the severity of eight dyspeptic symptoms was scored. Gastric emptying of solids and liquids were delayed in 23% and 35% of the patients. Multivariate analysis showed that the presence of vomiting and postprandial fullness was associated with delayed solid emptying (OR 2.65, 95% CI = 1.62-4.35 and OR 3.08, 95% CI = 1.28-9.16, respectively). Postprandial fullness was also associated with the risk of delayed liquid emptying when symptom was present (OR 3.5, 95% CI = 1.57-8.68), relevant or severe (OR 2.504, 95% CI = 1.41-4.65), and severe (OR 2.214, 95% CI = 1.34-3.67). Severe early satiety was associated with the risk of delayed liquid emptying (OR 1.902, 95% CI = 1.90-3.30). A subset of dyspeptic patients has delayed gastric emptying of solids or of liquids. Delayed gastric emptying of solids was constantly associated with postprandial fullness and with vomiting. Delayed emptying for liquids was also associated with postprandial fullness and with severe early satiety.
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              The relation between symptom improvement and gastric emptying in the treatment of diabetic and idiopathic gastroparesis.

              The relationship between symptom improvement (SI) and acceleration of gastric emptying (GE) for different drugs used in the treatment of idiopathic and diabetic gastroparesis is uncertain. In this paper we examined the study-specific correlations between SI and GE, and we performed a meta-regression analysis of the association across multiple studies.
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                Author and article information

                Journal
                American Journal of Physiology-Gastrointestinal and Liver Physiology
                American Journal of Physiology-Gastrointestinal and Liver Physiology
                American Physiological Society
                0193-1857
                1522-1547
                November 2017
                November 2017
                : 313
                : 5
                : G442-G447
                Affiliations
                [1 ]Division of Gastroenterology and Hepatology, Clinical Enteric Neuroscience Translational and Epidemiological Research, Mayo Clinic, Rochester, Minnesota; and
                [2 ]Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota
                Article
                10.1152/ajpgi.00190.2017
                5792209
                28774870
                bc517a0f-c278-4b7c-9704-998ecb6aca18
                © 2017
                History

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