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This version published online on November 4, 2004
Endocrinology, doi:10.1210/en.2004-0609
A more recent version of this article appeared on February 1, 2005
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Submitted on May 12, 2004
Accepted on October 13, 2004

Role of the Duodenum and Macronutrient Type in Ghrelin Regulation

Joost Overduin, R. Scott Frayo, Harvey J. Grill, Joel M. Kaplan, and David E. Cummings*

Department of Medicine, Division of Metabolism, Endocrinology and Nutrition, University of Washington, VA Puget Sound Health Care System, Seattle; Department of Psychology, University of Pennsylvania, Philadelphia, PA

* To whom correspondence should be addressed. E-mail: davidec{at}u.washington.edu.

The orexigenic hormone, ghrelin, is implicated in preprandial hunger and meal initiation, in part because circulating levels increase before meals and decrease after food intake. The mechanisms underlying postprandial ghrelin suppression are unknown. Although most ghrelin is produced by the stomach, we have shown that neither gastric nutrients nor gastric distension affect ghrelin levels. We hypothesized that the nutrient-sensing mechanism regulating ghrelin is in the duodenum, the second richest source of ghrelin. To test whether duodenal nutrient exposure is required for ghrelin suppression, we infused nutrients into either the proximal duodenum or proximal jejunum, in rats bearing chronic intestinal cannulas. At 0, 30, 60, 90, 120, 180, 240, and 300 min after infusions, blood was sampled via jugular-vein catheters for ghrelin, insulin, and glucose measurements. To elucidate further the mechanisms governing nutrient-related ghrelin suppression, we also assessed the ghrelin responses to isocaloric (3 kcal) infusions of glucose, amino acids, or lipids delivered into the stomach or small intestine of chronically catheterized rats. Regardless of macronutrient type, the depth and duration of ghrelin suppression were equivalent after gastric, duodenal, and jejunal infusions. Glucose and amino acids suppressed ghrelin more rapidly and strongly (by ~70%) than did lipids (by ~50%). Because jejunal nutrient infusions suppressed ghrelin levels as well as did either gastric or duodenal infusions, we conclude that the inhibitory signals mediating postprandial ghrelin suppression are not derived discretely from either the stomach or duodenum. The relatively weak suppression of ghrelin by lipids compared with glucose or amino acids could represent one mechanism promoting high-fat dietary weight gain.


Key words: ghrelin • macronutrients • diet • nutrient sensing • duodenum




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