Reliability of the time to maximal [^<13>CO_2] excretion and the half-[^<13>CO_2] excretion time as a gastric emptying parameter : Assessments using the Wagner-Nelson method
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概要
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In the [^<13>C]-octanoate breath test, two popular parameters have been used to quantify gastric emptying rates, namely the time to the maximal [^<13>CO_2] excretion (T_<max>) and the time to the half-[^<13>CO_2] recovery (T_<1/2b>). Although each of T_<max> and T_<1/2b> is closely correlated with the scintigraphic half-emptying time, the two parameters occasionally indicate different judgments on a gastric emptying rate. In this study, to clarify which of the two parameters is more reliable, T_<max> and T_<1/2b> were compared to the "reference" parameters calculated using the Wagner-Nelson method, which allows accurate estimation of a time-course of gastric emptying from breath data. Ten healthy male volunteers underwent the breath test after ingestion of a muffin meal (320kcal) containing 100mg [^<13>C]-octanoate. Breath samples were collected at 15-min intervals for 6h. According to the conventional analytical algorithm, T_<max> and T_<1/2b> were mathematically calculated. By applying Wagner-Nelson analysis to the breath test, the time-percent gastric retention curve was generated and the half-emptying time (T_<1/2WN>) was determined. T_<1/2WN> was more closely correlated with T_<max>(r=0.954, P<0.0001) than with T_<1/2b>(r=0.782, P=0.008). T_<max> was significantly correlated with the percent gastric retention value in the early (t=0.25 and 0.5h), the middle (t=1.0 and 1.5h), and the late (t=2.0h) postprandial phase. T_<1/2b> was significantly correlated with the gastric retention value in the middle and the late phase, but not with the gastric retention value in the early phase. The present results show that T_<1/2b> has limited capability to reflect gastric emptying in the early postprandial period, suggesting that T_<max> is more reliable than T_<1/2b> as a gastric emptying parameter.
著者
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YAMAMOTO Takatsugu
Department of Internal Medicine, Teikyo University School of Medicine
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KUYAMA Yasushi
Department of Internal Medicine, Teikyo University School of Medicine
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SANAKA Masaki
Department of Internal Medicine, Teikyo University School of Medicine
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山本 貴嗣
帝京大学附属病院内科
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NAKAYAMA Shin
Department of Hematology/Oncology, Research Hospital, Institute of Medical Science, University of To
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山本 貴嗣
帝京大学付属病院内科
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Sanaka M
Department Of Internal Medicine Tokyo Metropolitan Komagome Hospital
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Sanaka Masaki
Department Of General Medicine And Emergency Care Toho University School Of Medicine Omori Hospital
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Sanaka Masaki
Department Of Preventive Medicine Medical Research Institute Tokyo Medical And Dental University
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NAGASAWA Kunitaka
Department of Internal Medicine, School of Medicine, Teikyo University
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Yamamoto Takatsugu
Department Of Internal Medicine School Of Medicine Teikyo University
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Yamamoto Takatsugu
Department Of Internal Medicine Teikyo University School Of Medicine
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Kuyama Yasushi
Department Of Internal Medicine School Of Medicine Teikyo University
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Nagasawa Kunitaka
Department Of Internal Medicine School Of Medicine Teikyo University
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Nakayama Shin
Department Of Anesthesiology Institute Of Clinical Medicine University Of Tsukuba
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Nakayama Shin
Department Of Internal Medicine School Of Medicine Teikyo University
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