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Measurement of gastric emptying using a 13C-octanoic acid breath test with Wagner-Nelson analysis and scintigraphy in type 2 diabetes

Authors :
Michael A Nauck
Laurence G Trahair
Tongzhi Wu
Julie E Stevens
Madeline D Buttfield
Seva Hatzinikolas
Hung Pham
Juris J Meier
Christopher K Rayner
Michael Horowitz
Karen L Jones
Trahair, Laurence G
Nauck, Michael A
Wu, Tongzhi
Stevens, Julie E
Buttfield, Madeline D
Hatzinikolas, Seva
Pham, Hung
Meier, Juris J
Rayner, Christopher K
Horowitz, Michael
Jones, Karen L
Publication Year :
2022
Publisher :
Germany : Georg Thieme Verlag, 2022.

Abstract

Introduction Breath tests utilising 13C-labelled substrates for the assessment of gastric emptying have been applied widely. Wagner-Nelson analysis is a pharmacokinetic model that can be utilised to generate a gastric emptying curve from the % 13CO2 measured in breath samples. We compared Wagner-Nelson analysis with (i) scintigraphy and (ii) conventional breath test modelling to quantify gastric emptying in type 2 diabetes. Methods Thirteen patients (age 68.1±1.5 years, body mass index 31.0±0.9 kg/m2, HbA1c 6.3±0.2%) consumed a mashed potato meal comprising 65 g powdered potato, 20 g glucose, 250 ml water, an egg yolk labelled with 100 μL 13C-octanoic acid and 20MBq 99mTc-calcium phytate. Scintigraphic data were acquired and breath samples collected for 4 hours after the meal. Gastric emptying curves were derived based on each technique; the 50% emptying time and intragastric retention at 60 min were also calculated. Results With Wagner-Nelson analysis, a Kel=0.60 (the elimination constant) best approximated the scintigraphic gastric emptying curve. There was a relationship between the T50 calculated with scintigraphy and by both Wagner-Nelson Kel=0.60 (r2=0.45, P Conclusion In type 2 diabetes, gastric emptying of a mashed potato meal measured using a 13C-octanoic acid breath test analysed with Wagner-Nelson Kel=0.60 closely reflects measurements obtained with scintigraphy, whereas, in absolute terms, the conventional breath test analysis does not.

Details

Language :
English
Database :
OpenAIRE
Accession number :
edsair.doi.dedup.....cb9204246e473ec40efa21a4f4231dc4