technetium-tc-99m-sulfur-colloid and Obesity

Mexican Americans, a group at high risk for type II diabetes mellitus, have higher postprandial insulin and glucose levels when compared to non-Hispanic whites. A rapid rate of gastric emptying contributes to an increased rate of nutrient absorption and subsequent greater elevation of postprandial glucose and insulin levels. A more rapid rate of gastric emptying and hyperinsulinemia have been observed in patients with recently diagnosed type II diabetes mellitus. In this study, we examined whether Mexican Americans have a more rapid rate of gastric emptying than non-Hispanic whites. Gastric emptying studies were performed on 32 nondiabetic Mexican Americans and on 31 nondiabetic non-Hispanic whites. The rate of gastric emptying following a liquid glucose meal was measured. Serum insulin, plasma glucose, and GIP levels were measured in fasting and postprandial blood samples collected at 15-min intervals for 2 hr. Adjusting for age, body mass index, and gender, the gastric half-emptying time of a glucose meal was significantly (P < 0.05) more rapid for the Mexican American subjects (56.5 +/- 3.4 min) compared to the non-Hispanic white subjects (66.4 +/- 3.5 min). Nondiabetic Mexican Americans empty a liquid glucose meal more rapidly from their stomachs than nondiabetic non-Hispanic whites. Rapid gastric emptying is associated with hyperinsulinemia as a normal physiologic response to increased nutrient availability. The rapid gastric emptying observed in nondiabetic Mexican Americans is associated with hyperinsulinemia and could be a contributing factor for the increased risk of obesity and type II diabetes in this population.

Topics: Blood Glucose; Diabetes Mellitus, Type 2; Female; Gastric Emptying; Gastric Inhibitory Polypeptide; Glucose; Humans; Hyperinsulinism; Incidence; Insulin; Male; Mexican Americans; Mexico; Obesity; Risk Factors; Technetium Tc 99m Sulfur Colloid; White People

To determine the effect of the Garren-Edwards Gastric Bubble (GEGB) on gastric emptying, radionuclide solid and liquid gastric emptying in 12 obese patients prior to insertion of the GEGB was studied. Four were restudied at one and seven days and ten patients were restudied at twelve weeks with the GEGB in place. There were no significant differences in liquid gastric emptying at one and seven days nor in solid and liquid gastric emptying at twelve weeks. Solid gastric emptying was significantly decreased from a mean of 63% to 31% after one day (P less than 0.05) and returned to preplacement baseline by seven days. These results indicate that gastric emptying is not significantly changed after twelve weeks with the GEGB in place. Therefore, the mechanism of action for weight reduction with the GEGB is not likely to be mediated by an effect on gastric emptying. However, the solid food-induced dyspeptic symptoms commonly noted 1-3 days after placement of the GEGB, which resolve within seven days, are probably explained by transiently delayed solid gastric emptying.

Topics: Adolescent; Adult; Female; Gastric Emptying; Humans; Male; Middle Aged; Obesity; Prostheses and Implants; Radionuclide Imaging; Technetium Tc 99m Sulfur Colloid

Topics: Adult; Fatty Liver; Female; Humans; Liver; Liver Circulation; Male; Middle Aged; Obesity; Plethysmography; Technetium Tc 99m Sulfur Colloid

Quantitative gastric emptying essay by a single radio-nuclide technique (Tc99m), utilizing a fluid/solid meal, were performed in 2 groups of age-matched children: (a) 15 males with non-endocrine obesity; (b) 6 males and 3 females affected by gastroesophageal reflux, arbitrarily used as controls. Mean (+/- SD) gastric emptying rates, expressed as emptying half-time (T/2 in min) in the group a and b were superimposable (102.0 +/- 60.6 vs 97.3 +/- 43.1). Our data do not support the existence of an abnormally rapid gastric emptying rate in obesity, at least in pediatric age. This finding is even more striking if one considers that our control group was at high risk for delayed gastric emptying.

Topics: Child; Child, Preschool; Gastric Emptying; Humans; Male; Obesity; Radionuclide Imaging; Technetium Tc 99m Sulfur Colloid

Esophageal transit time as measured by radionuclide scintigraphy using a swallowed technetium sulfur colloid bolus was measured in obese patients with gastroesophageal reflux, lean patients with reflux, and lean volunteers without reflux. The esophageal transit time was significantly prolonged in the obese group compared with both lean groups (p less than 0.001). Esophageal manometric measurement also confirmed that obese patients have an elevated gastroesophageal pressure gradient, presumably caused by increased intraabdominal pressure resulting from the mechanical burden of excess fat. The esophageal transit time is significantly related to the gastroesophageal pressure gradient. This finding, coupled with those in previous manometric investigations showing that esophageal muscle has a decreased maximum velocity with increasing afterload, explains in part why obese patients have delayed esophageal transit time. Therapy for reflux in obese patients should be aimed at improving esophageal transit.

Topics: Adult; Aged; Esophagus; Gastroesophageal Reflux; Humans; Manometry; Middle Aged; Obesity; Peristalsis; Pressure; Radionuclide Imaging; Technetium Tc 99m Sulfur Colloid

Radioisotopic gastric emptying studies, using technetium-99m-sulfur-colloid-labeled egg, were performed in 14 patients who had undergone gastroplasty. The radioisotopic method was found to be a good quantitative indicator of the amount of solids that empty from the stomach and a useful tool in the longterm follow-up of gastroplasty patients. It was particularly helpful in evaluating the efficacy of surgery in patients with poor postsurgical weight reduction.

Topics: Adult; Body Weight; Female; Gastric Emptying; Humans; Male; Middle Aged; Obesity; Radionuclide Imaging; Stomach; Sulfur; Technetium; Technetium Tc 99m Sulfur Colloid