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2型糖尿病患者胃食管反流病的患病率及危险因素

Prevalence and Risk Factors of Gastroesophageal Reflux Disease in Patients with Type 2 Diabetes Mellitus.

作者信息

Ha Jun Ouk, Lee Tae Hee, Lee Chang Won, Park Ja Young, Choi Seong Ho, Park Hee Seung, Lee Jae Seung, Lee Seung Heon, Seo Eun Hee, Kim Young Hwan, Kang Young Woo

机构信息

Department of Internal Medicine, Busan St. Mary's Hospital, Busan, Korea.

Department of Internal Medicine, Konyang University College of Medicine, Daejeon, Korea.

出版信息

Diabetes Metab J. 2016 Aug;40(4):297-307. doi: 10.4093/dmj.2016.40.4.297. Epub 2016 Jun 8.

Abstract

BACKGROUND

Gastrointestinal symptoms are common in patients with type 2 diabetes mellitus (T2DM). The prevalence of gastroesophageal reflux disease (GERD) in Korea appears to be increasing. Some studies have shown that T2DM is a risk factor for symptomatic GERD. However, this possibility is still debated, and the pathogenesis of GERD in T2DM is not yet fully understood. The aim of this study was to analyze the prevalence and risk factors (including autonomic neuropathy) of GERD in patients with T2DM.

METHODS

This cross-sectional case-control study enrolled T2DM patients (n=258) and healthy controls (n=184). All participants underwent physical examinations and laboratory tests. We evaluated medical records and long-term diabetes complications, including peripheral and autonomic neuropathy in patients with T2DM. Esophagogastroduodenoscopy was performed in all patients. The Los Angeles (LA) classification was used to grade GERD. GERD was defined as LA grade A (or higher) or minimal change with GERD symptoms. GERD symptoms were examined using a frequency scale. Data were expressed as mean±standard error. Independent t-tests or chi-square tests were used to make comparisons between groups.

RESULTS

The prevalence of GERD (32.6% vs. 35.9%, P=0.266) and GERD symptoms (58.8% vs. 59.2%, P=0.503) was not significantly different between T2DM patients and controls. We found no significant differences between T2DM patients with GERD and T2DM patients without GERD with respect to diabetic complications, including autonomic neuropathy, peripheral neuropathy, duration of DM, and glucose control.

CONCLUSION

The prevalence of GERD in patients with T2DM showed no difference from that of controls. GERD was also not associated with peripheral and cardiovascular autonomic neuropathy, age, or duration of DM in patients with T2DM.

摘要

背景

胃肠道症状在2型糖尿病(T2DM)患者中很常见。韩国胃食管反流病(GERD)的患病率似乎在上升。一些研究表明,T2DM是症状性GERD的一个危险因素。然而,这种可能性仍存在争议,T2DM中GERD的发病机制尚未完全明确。本研究的目的是分析T2DM患者中GERD的患病率及其危险因素(包括自主神经病变)。

方法

这项横断面病例对照研究纳入了T2DM患者(n = 258)和健康对照者(n = 184)。所有参与者均接受了体格检查和实验室检查。我们评估了T2DM患者的病历及长期糖尿病并发症,包括周围神经病变和自主神经病变。所有患者均接受了食管胃十二指肠镜检查。采用洛杉矶(LA)分类法对GERD进行分级。GERD定义为LA分级A(或更高)或有GERD症状的轻微改变。使用频率量表检查GERD症状。数据以均值±标准误表示。采用独立t检验或卡方检验进行组间比较。

结果

T2DM患者和对照组之间GERD的患病率(32.6%对35.9%,P = 0.266)和GERD症状的发生率(58.8%对59.2%,P = 0.503)无显著差异。我们发现,在糖尿病并发症方面,包括自主神经病变、周围神经病变、糖尿病病程和血糖控制,患有GERD的T2DM患者与未患GERD的T2DM患者之间无显著差异。

结论

T2DM患者中GERD的患病率与对照组无差异。在T2DM患者中,GERD也与周围及心血管自主神经病变、年龄或糖尿病病程无关。

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