Each participant attended three visits and received a single 230 mmol dose of short chain fatty acids targeted to the small intestine, the same dose targeted to the colon, or placebo, with blood sampled for 8 hours afterwards.
PYY release was greater after colonic delivery, with an estimated difference of 111.46 pg/mL per hour (95% CI 4.33 to 218.59, p=0.04).
GLP-1 release went the other way. It was higher after small intestinal delivery by 16.00 pM per hour (95% CI 1.31 to 30.68, p=0.03), which the authors flag as unexpected.
Circulating short chain fatty acids were far higher after small intestinal delivery: acetate by 360.33 uM per hour (95% CI 226.50 to 494.17, p<0.001), propionate by 18.00 (95% CI 11.62 to 24.49, p<0.001) and butyrate by 7.21 (95% CI 3.77 to 10.66, p<0.001). Glucose and c peptide showed no effect of delivery site.
| PYY, colonic vs small intestinal | 111.46 pg/mL/h, 95% CI 4.33 to 218.59, p=0.04 |
| GLP-1, small intestinal vs colonic | 16.00 pM/h, 95% CI 1.31 to 30.68, p=0.03 |
| Circulating acetate, small intestinal vs colonic | 360.33 uM/h, 95% CI 226.50 to 494.17, p<0.001 |
| Circulating butyrate, small intestinal vs colonic | 7.21 uM/h, 95% CI 3.77 to 10.66, p<0.001 |
| Glucose and c peptide | no effect of delivery site |
Proposed by the authors This is the explanation the authors offer in their discussion. This study did not test it.
The authors set out two predictions before the trial. Small intestinal cells do not metabolise short chain fatty acids, so delivering there should push more into the bloodstream. Enteroendocrine cell density is lower in the small intestine, so hormone release should be smaller there.
The first prediction held convincingly. Systemic acetate, propionate and butyrate were all far higher after small intestinal delivery.
The PYY half held too, with more released after colonic delivery, as the density argument predicts.
The GLP-1 result broke the pattern and the authors say so, describing it as unexpected without offering a resolving explanation in the abstract. The discussion is not openly reachable, so we do not know what they went on to argue.
Drawn from Abstract, full text behind a publisher block.
Short chain fatty acids can no longer be treated as one intervention with one effect. Where they are released changes which hormone answers, and one of the two answers contradicted the standing anatomical explanation.
Twenty eight healthy adults given a single targeted dose, measured over 8 hours.
Repeating the delivery comparison in people with obesity or impaired glucose control, with food intake rather than a rating scale as the outcome, would show whether any of this changes eating.
Newsletter
Each issue by email, when the newsletter launches. Leaving your address puts you on the list, nothing is sent yet.