Download PDF
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)

Also available at
    Permissions and Reprints

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.

Schlüsselwörter

Appetit - Nahrungsaufnahme - gastrointestinale Signale - Cholezystokinin - GLP-1

Key words

Appetite - food intake - gastrointestinal signals - cholecystokinin - GLP-1

Literatur

  • 1 Pavlov I P. Beiträge zur Physiologie des Pankreas.  Pflügers Arch ges Physiol. 1878;  19 173-189
    PubMedSearch in Google Scholar
  • 2 Bayliss W M. Mechanisms of pancreatic secretion.  J Physiol. 1902;  28 325-353
    CrossrefPubMedSearch in Google Scholar
  • 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
    PubMedSearch in Google Scholar
  • 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
    PubMedSearch in Google Scholar
  • 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
    PubMedSearch in Google Scholar
  • 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
    CrossrefPubMedSearch in Google Scholar
  • 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
    PubMedSearch in Google Scholar
  • 8 Solomon T E. Control of exocrine pancreatic secretion. New York; Raven Press 1987
    Search in Google Scholar
  • 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
    CrossrefPubMedSearch in Google Scholar
  • 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
    PubMedSearch in Google Scholar
  • 11 Adler G, Nelson D K, Katschinski M, Beglinger C. Neurohormonal control of human pancreatic exocrine secretion.  Pancreas. 1995;  10 (1) 1-13
    PubMedSearch in Google Scholar
  • 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
    PubMedSearch in Google Scholar
  • 13 Adler G, Beglinger C. Hormones as regulators of pancreatic secretion in man.  Eur J Clin Invest. 1990;  20, Suppl 1 S 27-32
    PubMedSearch in Google Scholar
  • 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
    CrossrefPubMedSearch in Google Scholar
  • 15 Meyer J H. Gastric emptying of ordinary food: effect of antrum on particle size.  Am J Physiol. 1980;  239 (3) G 133-135
    PubMedSearch in Google Scholar
  • 16 Mayer E A. The Physiology of Gastric Storage and Emptying. Physiology of the Gastrointestinal Tract. New York; Raven Press 1994: 929-976
    Search in Google Scholar
  • 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
    PubMedSearch in Google Scholar
  • 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
    PubMedSearch in Google Scholar
  • 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
    CrossrefPubMedSearch in Google Scholar
  • 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
    PubMedSearch in Google Scholar
  • 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
    CrossrefPubMedSearch in Google Scholar
  • 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
    PubMedSearch in Google Scholar
  • 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
    PubMedSearch in Google Scholar
  • 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
    PubMedSearch in Google Scholar
  • 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
    PubMedSearch in Google Scholar
  • 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
    PubMedSearch in Google Scholar
  • 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
    PubMedSearch in Google Scholar
  • 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
    PubMedSearch in Google Scholar
  • 29 Blundell J E, Lawton C L, Halford J C. Serotonin, eating behavior, and fat intake.  Obes Res. 1995;  3, Suppl 4 471-476
    PubMedSearch in Google Scholar
  • 30 Blundell J E, Green S, Burley V. Carbohydrates and human appetite.  Am J Clin Nutr. 1994;  59 (Suppl 3) 728-734
    PubMedSearch in Google Scholar
  • 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
    PubMedSearch in Google Scholar
  • 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
    CrossrefPubMedSearch in Google Scholar
  • 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
    CrossrefPubMedSearch in Google Scholar
  • 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
    CrossrefPubMedSearch in Google Scholar
  • 35 Smith G P. The direct and indirect controls of meal size.  Neurosci Biobehav Rev. 1996;  20 (1) 41-46
    CrossrefPubMedSearch in Google Scholar
  • 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
    CrossrefPubMedSearch in Google Scholar
  • 37 Smith G P, Gibbs J. Gut peptides and postprandial satiety.  Fed Proc. 1984;  43 (14) 2889-2892
    PubMedSearch in Google Scholar
  • 38 Smith G P, Gibbs J. Cholecystokinin: a putative satiety signal.  Pharmacol Biochem Behav. 1975;  3 (Suppl 1) 135-138
    PubMedSearch in Google Scholar
  • 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
    PubMedSearch in Google Scholar
  • 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
    PubMedSearch in Google Scholar
  • 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
    CrossrefPubMedSearch in Google Scholar
  • 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
    PubMedSearch in Google Scholar
  • 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
    CrossrefPubMedSearch in Google Scholar
  • 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
    CrossrefPubMedSearch in Google Scholar
  • 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
    PubMedSearch in Google Scholar
  • 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
    PubMedSearch in Google Scholar
  • 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
    PubMedSearch in Google Scholar
  • 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
    PubMedSearch in Google Scholar
  • 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
    PubMedSearch in Google Scholar
  • 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
    PubMedSearch in Google Scholar
  • 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
    PubMedSearch in Google Scholar
  • 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
    CrossrefPubMedSearch in Google Scholar
  • 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
    PubMedSearch in Google Scholar
  • 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
    PubMedSearch in Google Scholar
  • 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
    PubMedSearch in Google Scholar
  • 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
    PubMedSearch in Google Scholar
  • 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
    CrossrefPubMedSearch in Google Scholar
  • 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
    PubMedSearch in Google Scholar
  • 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
    PubMedSearch in Google Scholar
  • 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
    PubMedSearch in Google Scholar
  • 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
    CrossrefPubMedSearch in Google Scholar
  • 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
    CrossrefPubMedSearch in Google Scholar
  • 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
    CrossrefPubMedSearch in Google Scholar
  • 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
    CrossrefPubMedSearch in Google Scholar
  • 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
    CrossrefPubMedSearch in Google Scholar
  • 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
    PubMedSearch in Google Scholar
  • 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
    PubMedSearch in Google Scholar

Prof. Dr. C. Beglinger

Abteilung für Gastroenterologie · Universitätsspital

4031 Basel · Schweiz