Department of Paediatrics, University Hospital of Geneva, Switzerland.
Eur J Gastroenterol Hepatol. 2011 Oct;23(10):881-5. doi: 10.1097/MEG.0b013e32834967b6.
The objective of the study was to evaluate gastric myoelectrical activity in young patients with diabetes and to correlate it with their metabolic control [fasting blood glucose, glycosylated haemoglobin, and fructosamine] and BMI during a 3 years follow-up.
Surface electrogastrography (EGG) was performed on 49 children with diabetes aged 10.3±4.4 (mean±SD) years and 17 age-matched healthy controls after fasting glucose, glycosylated haemoglobin, and fructosamine were measured. EGG parameters [percentage of bradygastria, 3 cycles per minute, tachygastria, dominant frequency instability coefficient, and power ratio] were analysed and compared with blood analysis.
Patients with diabetes exhibited an increase in preprandial bradygastria 7.9±8.8 cpm (mean±SD) compared with controls 2.1±1.0 (P=0.011), with an associated decrease in preprandial normogastria (72.2±14.5 vs. 82.7±14.7; P=0.013). Normogastric power ratio (postprandial/ preprandial power) was significantly increased in the children with diabetes compared with controls (mean: 6.67 vs. 3.14, P=0.034). A longer duration of diabetes was associated with an increased risk of EGG abnormalities (P=0.036). Marked hyperglycaemia at the time of study was associated with postprandial bradygastria (P=0.01) and power ratio bradygastria (P=0.042). Changes in glycosylated haemoglobin, fructosamine and BMI did not affect EGG parameters.
EGG abnormalities, presented early in a high proportion of diabetic children, are related to the acute hyperglycaemia. These abnormalities are not consistently present in the follow-up studies and not related to the glycosylated haemoglobin and fructosamine. Diabetic autonomic neuropathy is therefore an unlikely pathogenic factor for EGG abnormalities in children with diabetes.
本研究旨在评估年轻糖尿病患者的胃电活动，并将其与代谢控制[空腹血糖、糖化血红蛋白和果糖胺]以及 3 年随访期间的 BMI 相关联。
对 49 名年龄为 10.3±4.4（均值±标准差）岁的糖尿病患儿和 17 名年龄匹配的健康对照者进行空腹血糖、糖化血红蛋白和果糖胺检测后，行体表胃电图（EGG）检查。分析和比较 EGG 参数[慢波百分比、3 次/分钟、快波、主导频率不稳定性系数和功率比]与血液分析结果。
与对照组 2.1±1.0 cpm（均值±标准差）相比，糖尿病患儿餐前出现明显的胃慢波增多，为 7.9±8.8 cpm（P=0.011），且餐前正常胃电减少（72.2±14.5 与 82.7±14.7；P=0.013）。与对照组相比，糖尿病患儿餐后正常胃电功率比（餐后/餐前）显著增加（均值：6.67 与 3.14，P=0.034）。糖尿病病程较长与 EGG 异常风险增加相关（P=0.036）。研究时明显的高血糖与餐后胃慢波（P=0.01）和功率比胃慢波（P=0.042）相关。糖化血红蛋白、果糖胺和 BMI 的变化均不影响 EGG 参数。
糖尿病患儿中高比例出现的 EGG 异常与急性高血糖有关。这些异常在随访研究中并不常见，也与糖化血红蛋白和果糖胺无关。因此，糖尿病自主神经病变不太可能是儿童糖尿病 EGG 异常的致病因素。
