BMC Gastroenterol. 2013 Aug 23;13:132. doi: 10.1186/1471-230X-13-132.
Information about gastro-oesophageal reflux disease (GERD) in patients with Diabetes mellitus type 2 (T2D) is scarce, although the incidence of both disorders is increasing.
This "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.
In 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.
T2D 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.
Ethics committee of the Medical University of Vienna, IRB number 720/2011.
患有 2 型糖尿病（T2D）的患者中胃食管反流病（GERD）的信息很少，尽管这两种疾病的发病率都在增加。
这项“回顾性研究”将 65 名 T2D 患者与 130 名年龄和性别匹配的非糖尿病对照组进行比较。通过胃镜检查、测压、pH 测量和钡餐检查来确认 GERD。
与对照组相比，T2D 患者更常出现吞咽困难（32.3% vs. 13.1%；p = 0.001）和球感（27.7% vs. 13.8%；p = 0.021），而非糖尿病患者更常出现烧心（76.9% vs. 88.5%；p = 0.046）和反流（47.7% vs. 72.3%；p = 0.001）。尽管 T2D 患者的体重指数（BMI）更高（31.1 ± 5.2 与 27.7 ± 3.7 kg/m²；p < 0.001），但与对照组相比，T2D 患者的食管裂孔疝发生率较低（60.0% vs. 90.8%；p < 0.001）。T2D 患者的食管下括约肌（LES）压力较高（中位数 10.0 与 7.2 mmHg；p = 0.016）。两组的 DeMeester 评分无差异。T2D 患者的幽门螺杆菌感染更为常见（26.2% vs. 7.7%；p = 0.001）。T2D 患者的巴雷特化生（21.5% vs. 17.7%）、低级别（10.8% vs. 3.8%）和高级别（1.5% vs. 0%）异型增生更为常见。
与非糖尿病患者相比，T2D 患者表现出不同的 GERD 症状、更高的 LES 压力和较低的食管裂孔疝发生率，这可能与食管运动功能障碍有关，因此 GERD 更多是功能性而非解剖性的原因。T2D 患者的低度异型增生发生率是非糖尿病患者的两倍多。
维也纳医科大学伦理委员会，IRB 编号 720/2011。
