Effect of rectal infusion of short chain fatty acids in human subjects

Solutions containing 90 mmol sodium acetate plus 30 mmol sodium propionate (90 mM; isotonic), 180 mmol acetate plus 60 mmol propionate (180 mM; hypertonic) or an equivalent volume of isotonic saline were given over a 30-min period in random order by rectal infusion to six healthy subjects. Peripheral venous blood samples were obtained at 30-min intervals over the next 2 h. After the 90 mM infusion, the serum acetate response reached a peak at 60 min and had fallen to baseline by 120 min. The incremental area under the serum acetate response curve after 180 mM was twice that after 90 mM. Propionate was undetectable in serum at any time. Blood glucose fell after all of the infusions, but there was no significant difference between the saline- and short chain fatty acid (SCFA)-containing infusions. SCFA had no significant effect on serum insulin or c-peptide concentrations. However, compared with the saline control, the 180 mM solution resulted in a significant fall in serum free-fatty acids (FFA) and a significant rise in serum total cholesterol and triglyceride, with no change in beta-hydroxybutyrate levels. The data provide strong evidence that colonic SCFA are absorbed and metabolized in the human subject. The fall in FFA suggests that colonic SCFA have an effect on carbohydrate metabolism. In addition, the data provide indirect evidence for utilization of SCFA for lipid synthesis.