Document Detail

Role of lipase in the regulation of postprandial gastric acid secretion and emptying of fat in humans: a study with orlistat, a highly specific lipase inhibitor.
MedLine Citation:
PMID:  10807887     Owner:  NLM     Status:  MEDLINE    
BACKGROUND AND AIMS: To investigate the importance of lipase on gastric functions, we studied the effects of orlistat, a potent and specific inhibitor of lipase, on postprandial gastric acidity and gastric emptying of fat. METHODS: Fourteen healthy volunteers participated in a double blind, placebo controlled, randomised study. In a two way cross over study with two test periods of five days, separated by at least 14 days, orlistat 120 mg three times daily or placebo was given with standardised daily meals. In previous experiments we found that this dose almost completely inhibited postprandial duodenal lipase activity. Subjects underwent 28 hour intragastric pH-metry on day 4, and a gastric emptying study with a mixed meal (800 kcal) labelled with (999m)Tc sulphur colloid (solids) and (111In)thiocyanate (fat) on day 5. Gastric pH data were analysed for three postprandial hours and the interdigestive periods. RESULTS: Orlistat inhibited almost completely (by 75%) lipase activity and accelerated gastric emptying of both the solid (by 52%) and fat (by 44%) phases of the mixed meal (p<0.03). Orlistat increased postprandial gastric acidity (from a median pH of 3.3 to 2.7; p<0.01). Postprandial cholecystokinin release was lower with orlistat (p<0.03). CONCLUSION: Lipase has an important role in the regulation of postprandial gastric acid secretion and fat emptying in humans. These effects might be explained by lipolysis induced release of cholecystokinin.
J Borovicka; W Schwizer; G Guttmann; D Hartmann; M Kosinski; C Wastiel; A Bischof-Delaloye; M Fried
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Gut     Volume:  46     ISSN:  0017-5749     ISO Abbreviation:  Gut     Publication Date:  2000 Jun 
Date Detail:
Created Date:  2000-08-01     Completed Date:  2000-08-01     Revised Date:  2009-11-18    
Medline Journal Info:
Nlm Unique ID:  2985108R     Medline TA:  Gut     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  774-81     Citation Subset:  AIM; IM    
Gastroenterology and Nuclear Medicine Departments, University Hospitals, Lausanne and Zurich, Switzerland.
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MeSH Terms
Cholecystokinin / blood
Dietary Fats / pharmacokinetics*
Double-Blind Method
Enzyme Inhibitors / pharmacology
Gastric Acid / secretion*
Gastric Emptying / physiology
Gastrins / blood
Hydrogen-Ion Concentration
Lactones / pharmacology
Lipase / antagonists & inhibitors,  physiology*
Postprandial Period
Reg. No./Substance:
0/Dietary Fats; 0/Enzyme Inhibitors; 0/Gastrins; 0/Lactones; 9011-97-6/Cholecystokinin; 96829-58-2/orlistat; EC

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