title: Role of cholecystokinin in relaxation of the proximal stomach.
abstract: Ingestion of a meal causes proximal gastric relaxation (accommodation). The magnitude of accommodation is related to the fat content of the meal. A role for cholecystokinin (CCK) has been suggested. However, under fasting conditions intravenous CCK to postprandial levels does not induce a similar accommodation. This study further explores the role of CCK in accommodation. A gastric barostat was used in eight healthy persons to study accommodation in response to a carbohydrate meal with intravenous CCK (CH-CCK), carbohydrate meal with intravenous placebo (CH-placebo) and a fat rich meal with intravenous placebo (FAT). VAS scores for satiety and plasma CCK levels were obtained. In the first postprandial hour the FAT meal induced a relaxation of 112 +/- 29 ml, the CH-CCK meal 49 +/- 36 ml and the CH-placebo meal 12 +/- 32 ml (FAT versus CH-placebo P = 0.03; FAT versus CH-CCK P = 0.09). In the second postprandial hour, intragastric bag volume returned to baseline with all meals. The FAT meal had the most pronounced effect with respect to satiety, CH-placebo the least. In the first postprandial hour, plasma CCK levels increased with the CH-CCK and FAT meals but not with the CH-placebo meal; in the second postprandial hour, levels remained elevated with the CH-CCK meal. It is concluded that a carbohydrate meal with exogenous CCK does not induce fundic relaxation, whereas a fat-rich meal (endogenous CCK) does, despite similar plasma CCK levels.
authors.affiliation: Dept. of Gastroenterology-Hepatology, Leiden University Medical Center, The Netherlands.
authors.forename: P J
authors.initials: PJ
authors.lastname: van der Schaar
authors.forename: Y
authors.initials: Y
authors.lastname: Bremer
authors.forename: C B
authors.initials: CB
authors.lastname: Lamers
authors.forename: A A
authors.initials: AA
authors.lastname: Masclee
mesh_terms: D000328:Adult; D002766:Cholecystokinin / Q000008:administration & dosage / Q000378:metabolism*; D004040:Dietary Carbohydrates / Q000008:administration & dosage*; D004041:Dietary Fats / Q000008:administration & dosage*; D004063:Digestion / Q000187:drug effects / Q000502:physiology; D005260:Female; D005769:Gastrointestinal Motility / Q000502:physiology*; D006801:Humans; D007275:Injections, Intravenous; D008297:Male; D008365:Manometry; D015999:Multivariate Analysis; D009126:Muscle Relaxation / Q000502:physiology; D019518:Postprandial Period / Q000502:physiology*; D011336:Probability; D012016:Reference Values; D012680:Sensitivity and Specificity; D013270:Stomach / Q000187:drug effects / Q000502:physiology*
chemical_list: D004040:Dietary Carbohydrates; D004041:Dietary Fats; D002766:Cholecystokinin