Gastro-oesophageal reflux disease in type 2 diabetics: symptom load and pathophysiologic aspects - a retro-pro study

BMC Gastroenterology

Research Article

Johannes Ott¹  Johannes Lenglinger²  Franz Martin Riegler²  Wolf Hans Eilenberg²  Regina Promberger²  Christoph Neumayer³  Michael Gadenstätter⁴  Gernot Seebacher⁴  Otto Riedl⁵ 

[1] Department of Gynecology and Obstetrics, Medical University of Vienna, Vienna, Austria;Division of General Surgery, Department of Surgery, Medical University of Vienna, Vienna, Austria;Division of Vascular Surgery, Department of Surgery, Medical University of Vienna, Vienna, Austria;Karl Landsteiner Institute for Clinical Surgery, General Hospital of Krems, Krems, Austria;Karl Landsteiner Institute for Clinical Surgery, General Hospital of Krems, Krems, Austria;Division of Plastic and Reconstructive Surgery, Department of Surgery, Medical University of Vienna, Vienna, Austria;

关键词: Diabetes;    GERD;    Dysphagia;    Heartburn;    Hiatal hernia;   

DOI  :  10.1186/1471-230X-13-132

 received in 2013-03-21, accepted in 2013-08-14,  发布年份 2013

来源: Springer

【 摘 要 】

BackgroundInformation about gastro-oesophageal reflux disease (GERD) in patients with Diabetes mellitus type 2 (T2D) is scarce, although the incidence of both disorders is increasing.We aimed to determine GERD symptoms and their underlying pathophysiologic characteristics in T2D patients.MethodsThis “retro-pro” study compared 65 T2D patients to a control group of 130 age- and sex-matched non-diabetics. GERD was confirmed by gastroscopy, manometry, pH-metry and barium swallow.ResultsIn patients with T2D compared to controls, dysphagia (32.3% vs. 13.1%; p = 0.001) and globus sensation (27.7% vs. 13.8%; p = 0.021) were found more frequently, whereas heartburn (76.9% vs. 88.5%; p = 0.046) and regurgitation (47.7% vs. 72.3%; p = 0.001) were predominant in non-diabetics. Despite higher body mass indices (31.1 ± 5.2 vs. 27.7 ± 3.7 kg/m2; p < 0.001), hiatal hernia was less frequent in T2D patients compared to controls (60.0% vs. 90.8%, p < 0.001). Lower oesophageal sphincter (LES) pressure was higher in patients with T2D (median 10.0 vs. 7.2 mmHg, p = 0.016). DeMeester scores did not differ between the groups. Helicobacter pylori infections were more common in T2D patients (26.2% vs. 7.7%, p = 0.001). Barrett metaplasia (21.5% vs. 17.7%), as well as low- (10.8% vs. 3.8%) and high-grade dysplasia (1.5% vs. 0%) were predominant in T2D patients.ConclusionsT2D patients exhibit different GERD symptoms, higher LES pressures and a decreased prevalence of hiatal hernia than non-diabetics, which may be related to worse oesophageal motility and, thus, a more functional rather than anatomical cause of GERD. Low-grade dysplasia was more than twice as high in T2D than in non-diabetics patients.Trial registrationEthics committee of the Medical University of Vienna, IRBnumber720/2011.

【 授权许可】

Unknown   
© Promberger et al.; licensee BioMed Central Ltd. 2013. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.