title: Effect of gastric volume or emptying on meal-related symptoms after liquid nutrients in obesity: a pharmacologic study.
abstract: OBJECTIVE
  Altered postprandial satiation influences food intake in obesity. The aim of this study was to evaluate the contribution of gastric motor functions to intra- and postprandial symptoms in obese, otherwise healthy, people.
  
  
  METHODS
  In a randomized, parallel-group, double-blind design, 40 obese (body mass index>30 kg/m2) healthy volunteers (n=10/group) received intravenous saline (placebo), atropine (.02 mg/kg), or erythromycin (1 or 3 mg/kg) to alter gastric volume and emptying after liquid nutrient meals, measured by validated imaging methods. The nutrient drink test assessed the volume ingested at maximum satiation, and intra- and early postprandial symptoms. Relationships between gastric motor functions, meal size, and symptoms were assessed by using multiple regression. Circulating levels of candidate upper-gut hormones involved in satiation were measured.
  
  
  RESULTS
  Relative to placebo, atropine retarded gastric emptying and increased gastric volumes; erythromycin accelerated gastric emptying and reduced gastric volumes during fasting. Although similar maximal tolerated volumes were recorded across treatments, intra- and immediate postprandial symptoms were increased by these perturbations, particularly nausea and bloating. Upper-gut hormonal profiles generally reflected changes in gastric emptying. Regression analysis showed that fasting predrug gastric volume was a significant predictor of intra- and postprandial bloating. Change in gastric volume postdrug or postmeal did not contribute additionally to predicting intra- or postprandial symptoms. There was significant (negative) association between gastric emptying and fullness score, and significant (positive) association with hunger score 30 minutes postprandially.
  
  
  CONCLUSIONS
  In obese individuals, fasting gastric volumes and gastric emptying, but not postprandial gastric volumes, were associated with intra- and postprandial symptoms. Understanding the determinants of gastric volume may provide insights on mechanisms controlling satiation.
authors.affiliation: Clinical Enteric Neuroscience Translational and Epidemiological Research (CENTER) Program, Mayo Clinic College of Medicine, Rochester, Minnesota 55905, USA.
authors.forename: Silvia
authors.initials: S
authors.lastname: Delgado-Aros
authors.forename: Michael
authors.initials: M
authors.lastname: Camilleri
authors.forename: E Janet
authors.initials: EJ
authors.lastname: Castillo
authors.forename: Filippo
authors.initials: F
authors.lastname: Cremonini
authors.forename: Debra
authors.initials: D
authors.lastname: Stephens
authors.forename: Irene
authors.initials: I
authors.lastname: Ferber
authors.forename: Kari
authors.initials: K
authors.lastname: Baxter
authors.forename: Duane
authors.initials: D
authors.lastname: Burton
authors.forename: Alan R
authors.initials: AR
authors.lastname: Zinsmeister
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001285:Atropine / Q000494:pharmacology; D004311:Double-Blind Method; D004917:Erythromycin / Q000494:pharmacology; D005260:Female; D005746:Gastric Emptying / Q000187:drug effects / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000178:diet therapy* / Q000503:physiopathology*; D010191:Pancreatic Polypeptide / Q000097:blood; D012044:Regression Analysis; D013270:Stomach / Q000187:drug effects / Q000503:physiopathology*
chemical_list: D010191:Pancreatic Polypeptide; D004917:Erythromycin; D001285:Atropine