Wang Xiangbing, Pitchumoni C S, Chandrarana Khushbu, Shah Neha
Division of Endocrinology and Metabolism, Robert Wood Johnson University Hospital-UMDNJ, MEB 384B, 1 RWJ place, PO Box 19, New Brunswick, NJ 08903-0019, United States.
World J Gastroenterol. 2008 Feb 7;14(5):709-12. doi: 10.3748/wjg.14.709.
To analyze the prevalence of gastroesophageal reflux disease (GERD) related symptoms in patients with diabetes mellitus (DM) and to find out the relationship between diabetic neuropathy and the prevalence of GERD symptoms.
In this prospective questionnaire study, 150 consecutive type 2 diabetic patients attending the endocrine clinic were enrolled. A junior physician helped the patients to understand the questions. Patients were asked about the presence of five most frequent symptoms of GERD that included heartburn (at least 1/wk), regurgitation, chest pain, hoarseness of voice and chronic cough. Patients with past medical history of angina, COPD, asthma, cough due to ACEI or preexisting GERD prior to onset of diabetes and apparent psychiatric disorders were excluded from the survey. We further divided the patients into two groups based on presence or absence of peripheral neuropathy. Out of 150 patients, 46 had neuropathy, whereas 104 patients did not have neuropathy. Data are expressed as mean +/- SD, and number of patients in each category and percentage of total patients in that group. Normal distributions between groups were compared with Student t test and the prevalence rates between groups were compared with Chi-square tests for significance.
The average duration of diabetes were 12 +/- 9.2 years and the average HbA1c level of this group was 7.7% +/- 2.0%. The mean weight and BMI were 198 +/- 54 lbs. and 32 +/- 7.2 kg/m2. Forty percent (61/150) patients reported having at least one of the symptoms of GERD and thirty percent (45/150) reported having heartburn at least once a week. The prevalence of GERD symptoms is higher in patients with neuropathy than patients without neuropathy (58.7% vs 32.7%, P < 0.01). The prevalence of heartburn, chest pain and chronic cough are also higher in patients with neuropathy than in patients without neuropathy (43.5% vs 24%; 10.9% vs 4.8% and 17.8% vs 6.7% respectively, P < 0.05).
The prevalence of GERD symptoms in type 2 DM is higher than in the general population. Our data suggest that DM neuropathy may be an important associated factor for developing GERD symptoms.
分析糖尿病（DM）患者中胃食管反流病（GERD）相关症状的患病率，并找出糖尿病神经病变与GERD症状患病率之间的关系。
在这项前瞻性问卷调查研究中，纳入了150名连续就诊于内分泌门诊的2型糖尿病患者。一名初级医生帮助患者理解问题。询问患者是否存在GERD最常见的五种症状，包括烧心（至少每周1次）、反流、胸痛、声音嘶哑和慢性咳嗽。有心绞痛、慢性阻塞性肺疾病（COPD）、哮喘病史、因使用血管紧张素转换酶抑制剂（ACEI）引起咳嗽病史或糖尿病发病前已有GERD病史以及明显精神障碍的患者被排除在调查之外。我们根据是否存在周围神经病变将患者进一步分为两组。150名患者中，46名有神经病变，而104名患者没有神经病变。数据以均值±标准差、每组患者数量以及该组患者占总患者数的百分比表示。组间正态分布采用Student t检验进行比较，组间患病率采用卡方检验进行显著性比较。
糖尿病平均病程为12±9.2年，该组患者平均糖化血红蛋白（HbA1c）水平为7.7%±2.0%。平均体重和体重指数（BMI）分别为198±54磅和32±7.2kg/m²。40%（61/150）的患者报告至少有一项GERD症状，30%（45/150）的患者报告至少每周有一次烧心症状。有神经病变的患者中GERD症状的患病率高于无神经病变的患者（58.7%对32.7%，P<0.01）。有神经病变的患者中烧心、胸痛和慢性咳嗽的患病率也高于无神经病变的患者（分别为43.5%对24%；10.9%对4.8%和17.8%对6.7%，P<0.05）。
2型糖尿病患者中GERD症状的患病率高于一般人群。我们的数据表明，糖尿病神经病变可能是发生GERD症状的一个重要相关因素。
