The influence of a preserved colon on the absorption of medium chain fat in patients with small bowel resection
The influence of a preserved colon on the absorption of medium chain fat in patients with small bowel resection
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DOI：
10.1136/gut.43.4.478
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发表时间：
1998-10-01
期刊：
影响因子：
24.5
通讯作者：
Mortensen, PB
中科院分区：
文献类型：
--
作者：
Jeppesen, PB;Mortensen, PB
背景-中链 C8-C10 甘油三酯 (MCT) 可改善短肠患者的脂肪吸收。对总体能量吸收的影响仍然未知。目的 - 确定 MCT 和中链脂肪酸 (MCFA) 是否像短链脂肪酸 (SCFA) 一样在结肠中被吸收，或者与长链脂肪酸 (LCFA) 类似地在粪便中丢失。方法 - 9 名未切除小肠的患者和 10 名连续结肠切除的患者每天排泄 2-6 MJ，并随机并在两种高脂肪饮食之间交叉（10 MJ/天， 50% 作为脂肪），基于单独的长链甘油三酯 (LCT) 或等量的 LCT 和 MCT。 结果 - 在类似和极端水平的 LCFA 吸收不良情况下，有结肠的患者吸收 C8-C10 脂肪酸的效果明显好于无结肠的患者；结肠对 C14-18 脂肪酸吸收的影响可以忽略不计。 MCT 使结肠患者的脂肪 (MCT+LCT) 吸收从 23% 增加到 58%，并将总体炸弹热量吸收从 46% 增加到 58%。在没有结肠的患者中，脂肪吸收增加了37%至46%，但并没有改善总体能量吸收，因为碳水化合物和蛋白质的吸收不良增加了。结论——在小肠切除的患者中，结肠似乎充当中链脂肪的消化器官，可能以MCFA的形式被吸收，也许是因为它们像SCFA一样是水溶性的。只有结肠患者才能从 MCT 治疗中获益。
Background-Medium chain C8-C10 triglycerides (MCTs) improve fat absorption in short bowel patients. Effects on overall energy absorption remain unknown .Aims-To determine whether MCTs and medium chain fatty acids (MCFAs) are absorbed in the colon like the short chain fatty acids (SCFAs) or are lost in faeces similarly to long chain fatty acids (LCFAs).Methods-Nine small bowel resected patients without and 10 with a colon in continuity excreted 2-6 MJ/day and were randomised and crossed over between two high fat diets (10 MJ/day, 50% as fat), based on either long chain triglycerides (LCT) alone or equal quantities of LCT and MCT.Results-Patients with a colon absorbed C8-C10 fatty acids considerably better than patients without a colon at similar and extreme levels of LCFA malabsorption; the colonic impact on absorption of C14-18 fatty acids was negligible. MCT redoubled fat (MCT+LCT) absorption from 23% to 58% in patients with a colon, and increased overall bomb calorimetric energy absorption from 46% to 58%. The increase in fat absorption 37% to 46% in patients without a colon did not improve overall energy absorption because malabsorption of carbohydrate and protein increased.Conclusion-In small bowel resected patients, the colon seems to serve as a digestive organ for medium chain fat, probably absorbed as MCFAs, perhaps because like the SCFAs, they are water soluble. Only patients with a colon gained from MCT treatment.