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与糖尿病相关的胃食管反流病:241例2型糖尿病患者分析

Gastroesophageal reflux disease related to diabetes: Analysis of 241 cases with type 2 diabetes mellitus.

作者信息

Nishida Tsutomu, Tsuji Shingo, Tsujii Masahiko, Arimitsu Shoko, Sato Tomonobu, Haruna Yoshimichi, Miyamoto Takashi, Kanda Tsutomu, Kawano Sunao, Hori Masatsugu

机构信息

Department of Internal Medicine and Therapeutics, Osaka University Graduate School of Medicine, Osaka, Japan.

出版信息

J Gastroenterol Hepatol. 2004 Mar;19(3):258-65. doi: 10.1111/j.1440-1746.2003.03288.x.

Abstract

BACKGROUND AND AIM

We examined the incidence of symptomatic gastroesophageal reflux disease (GERD) in patients with type 2 diabetes mellitus (DM).

METHODS

Patients comprised those with DM or chronic hepatitis C (CHC) who visited Osaka Prefectural General Hospital in the same study period. Reflux symptoms were examined using a self-administered questionnaire. A total score of 4 or more was considered an indication of symptomatic GERD. Disease duration, hemoglobinA1c and diabetic complications were assessed.

RESULTS

Patients with DM (n=241) or CHC (n=42) were recruited for the study. Of the 241 patients with DM, 100 (41.5%) reported experiencing upper gastrointestinal symptoms, whereas only 9 of 42 (21.4%) patients with CHC reported upper gastrointestinal symptoms (P=0.0137). Sixty-one patients (25.3%) with DM had reflux symptoms but only four patients (9.5%) with CHC reported reflux symptoms. The incidence of symptomatic GERD was significantly higher in patients with DM than in those with CHC (P=0.0219). Patients with DM for less than 5 years had a 2.4-fold higher incidence of GERD than patients with CHC. The incidence tended to rise with increased disease duration. Patients with diabetic complications reported reflux symptoms more frequently. The incidence decreased, however, in DM patients who had these conditions for more than 16 years.

CONCLUSIONS

Type 2 diabetes mellitus is a risk factor for symptomatic GERD. In DM patients, use of oral hypoglycemic agents, body mass index, disease duration and the quality of diabetic control influenced the incidence of GERD.

摘要

背景与目的

我们研究了2型糖尿病(DM)患者中症状性胃食管反流病(GERD)的发生率。

方法

研究对象为在同一研究期间就诊于大阪府立综合医院的DM患者或慢性丙型肝炎(CHC)患者。使用自行填写的问卷对反流症状进行调查。总分4分及以上被视为症状性GERD的指征。评估疾病病程、糖化血红蛋白和糖尿病并发症。

结果

招募了DM患者(n = 241)或CHC患者(n = 42)进行研究。在241例DM患者中,100例(41.5%)报告有上消化道症状,而42例CHC患者中只有9例(21.4%)报告有上消化道症状(P = 0.0137)。61例(25.3%)DM患者有反流症状,但只有4例(9.5%)CHC患者报告有反流症状。DM患者中症状性GERD的发生率显著高于CHC患者(P = 0.0219)。病程小于5年的DM患者GERD发生率比CHC患者高2.4倍。发生率往往随病程延长而上升。有糖尿病并发症的患者反流症状报告更频繁。然而,在患有这些疾病超过16年的DM患者中,发生率有所下降。

结论

2型糖尿病是症状性GERD的一个危险因素。在DM患者中,口服降糖药的使用、体重指数、病程和糖尿病控制质量影响GERD的发生率。

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