High body mass alters colonic sensory-motor function and transit in humans
High body mass alters colonic sensory-motor function and transit in humans
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DOI：
10.1152/ajpgi.90286.2008
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发表时间：
2008-08-01
影响因子：
4.5
通讯作者：
Busciglio, Irene
中科院分区：
文献类型：
--
作者：
Delgado-Aros, Silvia;Camilleri, Michael;Busciglio, Irene
随着体重指数（BMI）的增加，腹痛和腹泻的患病率增加，胃感觉减弱。我们的假设是，体重指数的增加与结肠运动和感觉的增加有关。研究目的是评估BMI对结肠感觉和运动功能以及转运的影响。我们使用了一个数据库，记录了健康肥胖和非肥胖受试者的结肠张力、顺应性和结肠内、气压控制球囊测量的膨胀感，并通过有效的闪烁成像测量了胃肠道运输。采用回归分析评估BMI与结肠感觉和运动功能的关系。我们纳入了性别差异、年龄、身高、膨胀时球囊体积和心理压力的调整。在165名参与者中（87名女性，78名男性），BMI增加与结肠顺应性降低（P < 0.006，校正），肿胀期间疼痛等级降低（P = 0.02，校正）和更高的疼痛阈值（P = 0.042，校正）相关。进食后的气感、结肠张力和收缩与BMI无显著相关性。对72名参与者（41名女性，31名男性）的交通状况进行了评估；BMI为30 kg/m时，结肠运输速度更快(2)（未经调整P = 0.003，性别调整P = 0.08）。综上所述，BMI > 25 kg/m(2)与结肠顺应性和痛感降低有关；结肠运输加速，尤其是当女性体重指数达到30 kg/ m2时。这些数据表明，结肠功能障碍可能导致腹泻，但肥胖患者腹痛增加的原因并不能通过结肠感觉的研究来解释，需要进一步研究传入、脊柱和中枢机制。
There is increased prevalence of abdominal pain and diarrhea and decreased gastric sensation with increased body mass index (BMI). Our hypothesis is that increased BMI is associated with increased colonic motility and sensation. The study aim was to assess effect of BMI on colonic sensory and motor functions and transit. We used a database of colonic tone, compliance, and perception of distensions measured by intracolonic, barostat-controlled balloon, and gastrointestinal transit was measured by validated scintigraphy in healthy obese and nonobese subjects. Regression analysis was applied to assess the association of BMI with colonic sensory and motor functions. We included adjustments for sex differences, age, height, balloon volumes during distension, and psychological stress. Among 165 participants (87 women, 78 men), increased BMI was associated with decreased colonic compliance (P < 0.006, adjusted), decreased pain rating during distensions (P = 0.02, adjusted), and a higher threshold for pain (P = 0.042, adjusted). Sensation for gas, colonic tone, and contraction after meal ingestion were not significantly associated with BMI. Transit was assessed in 72 participants (41 women, 31 men); colonic transit was faster with BMI > 30 kg/m(2) (P = 0.003 unadjusted, P = 0.08 adjusted for gender). In conclusion, BMI > 25 kg/m(2) is associated with decreased colonic compliance and pain sensation; colonic transit is accelerated particularly with BMI > 30 kg/m(2) in women. These data suggest that colonic dysfunction may contribute to diarrhea, but the cause of increased abdominal pain in obesity is not explained by the studies of colonic sensation and requires further study of afferent, spinal, and central mechanisms.