Watching fat digestion: a microscopic method assessing intraluminal lipolysis.
We investigated the utility of a microscopic method assessing lipolytic activity of duodenal fluid. The method is based on evaluating microscopically physicochemical changes along time when olive oil is mixed with duodenal fluid in the presence of excess bile salts (13 mM) and calcium ions (8 mM) at pH 6.5. Data are analyzed on duodenal aspirations from 155 children referred for failure to thrive or gastrointestinal disorders. The "fat digestion index" (FDI) is the percentage of intact olive oil droplets that underwent complete hydrolysis or are transformed into amorphous reticular bodies (ARB) at steady state. In all patients with proven exocrine pancreatic disorder, a FDI less than 25% was found. This value was thus considered as a cut-off value. When no microscopic lipolysis (FDI = 0) was observed, exocrine pancreatic enzyme assays are suggestive for a total exocrine pancreatic insufficiency. In the group of children with FDI ranging 5-25%, however, no statistical difference in exocrine pancreatic enzymes could be found, as compared to control values. Our tests thus evaluate fat digestion in a dynamic way. It further seems to give additional information on intraluminal lipolysis as compared to exocrine pancreatic enzyme concentrations, since it gives an idea about the integrated action of (co)lipase and bile salts.
Alliet
P
P
Department of Pediatrics, University Hospital, Gasthuisberg, Leuven.
Eggermont
E
E
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D004063:Digestion; D004386:Duodenum / Q000378:metabolism; D005260:Female; D005767:Gastrointestinal Diseases / Q000378:metabolism*; D006801:Humans; D007223:Infant; D007419:Intestinal Secretions / Q000201:enzymology / Q000378:metabolism*; D008066:Lipolysis; D008297:Male; D010186:Pancreatic Function Tests; D010938:Plant Oils / Q000378:metabolism
D010938:Plant Oils