| Background/AimsDiabetes Mellitus is a common chronic disease in China. It is progressively becoming a serious public health problem because of its highly morbidity and extensive complications. Since the first description of gastroparesis diabeticorum by Kassander, several epidemiological as well as clinical studies have found that about 30%-50% of type 2 diabetics have diabetic gastroparesis. It is manifested by not only dyspeptic symptoms, but also delayed gastric emptying. Although much is known about the abnormal gastric motor function in diabetics, little is known about the mechanism of delayed gastric emptying. Recent data regarding pathogenesis are confusing and unclear. The pathogenesis of diabetic gastroparesis is sometimes linked with autonomic neuropathy, gastrointestinal hormones, hyperglycemia or a myogenic mechanism. This study will analyze the relationship between diabetic gastroparesis and gastrointestinalhormones. MethodsGastric emptying was evaluated with Emission Computed Tomography in 61 type 2 diabetics and 16 healthy volunteers. We also evaluated the age, history, blood sugar, HbAlc, gastrin, motilin and glucagon in the diabetics. ResultsHalf time gastric emptying of liquid was 14.9 + 5.1 minutes and 15.80?.34 minutes in the control group and diabetic group respectively. Half time gastric emptying of solid was 44.2+12.8 minutes and 65.10 + 27.77 minutes in the control group and diabetic group respectively. There was significant difference between the two groups for half time gastric emptying of solids (p<0. 01). Nine diabetic patients (14. 75%)had delayed gastric emptying of liquid. Thirty-five diabetic patients (57.38%)had delayed gastric emptying of solid.In the group with FBS <126mg/dl, one of eighteen (5. 56%) patients had delayed gastric emptying of liquid and six of eighteen (33. 33%) patients had delayed gastric emptying of solid. In the group with FBS >126mg/dl, eight of 43 (18. 60%) patients had delayed gastric emptying of liquid and twenty-nine of 43 (67. 44%) patients had delayed gastric emptying of solid. There was a significant difference between these two groups for half time gastric emptying of liquid and solid (p<0. 01).In the group with HbAlc <7. 3%, seventeen patients all had normal gastric emptying of liquid and ten of 17 (58. 82%) patients had delayed gastric emptying of solid. In the group with HbAlc >7.3%, nine of44(20.45%) patients had delayed gastric emptying of liquid and twenty-five of 44(56.82%) patients had delayed gastric emptying of solid. There was a significant difference between the two groups for half time gastric emptying of liquid (p<0.01) only. But In the group with HbAlc <6. 3%, two of six patients (33.33%) had delayed gastric emptying of solid. In the group with HbAlc >6.3%, thirty-three of fifty-five patients (60.0%) had delayed gastric emptying of solid. There was a significant difference between the two groups for half time gastric emptying of liquid and solids.Half time gastric emptying of liquid and solids between groups with different ages and history had no significant difference (P>0.05).61 type 2 diabetics were divided into groups of normal gastric emptying and gastroparesis. The serum fasting and postprandial gastrin were 99. 25 + 38. 02 pg/ml and 74. 45?6. 29 pg/ml for the normal gastric emptying group. The serum fasting and postprandial gastrin were 102.91?8. 56 pg/ml and 102.91?8.56 pg/ml for the gastroparesis group. There was no significant difference between the two groups (P>0.05).The plasma fasting and postprandial motilin were 146. 06?6. 02 pg/ml and 138. 4512 + 97. 93 pg/ml for the normal gastric emptying group. The plasma fasting and postprandial motilin were 346. 97?160. 44 pg/ml and 346.34+145.61 pg/ml for the gastroparesis group. There was a significant difference between the two groups (p<0.001).The plasma fasting and postprandial glucagons were 270. 34+148. 78 pg/ml and 252. 82+100. 78 pg/ml for the normal gastric emptying group.The plasma fasting and postprandial glucagons were 27...
|
PDF Full Text Request