Siraj Elias S, Homko Carol, Wilson Laura A, May Patrick, Rao Ajay D, Calles Jorge, Farrugia Gianrico, Hasler William L, Koch Kenneth L, Nguyen Linda, Snape William J, Abell Thomas L, Sarosiek Irene, McCallum Richard W, Pasricha Pankaj J, Clarke John, Tonascia James, Hamilton Frank, Parkman Henry P
Division of Endocrinology and Metabolic Disorders, Eastern Virginia Medical School, Norfolk, VA, United States.
Lewis Katz School of Medicine, Temple University, Philadelphia, PA, United States.
Front Endocrinol (Lausanne). 2018 Feb 13;9:32. doi: 10.3389/fendo.2018.00032. eCollection 2018.
Individuals with diabetes are at increased risk for complications, including gastroparesis. Type 1 diabetes mellitus (T1DM) is an autoimmune disorder resulting in decreased beta-cell function. Glutamic acid decarboxylase-65 antibody (GADA) is the most commonly used test to assess autoimmunity while C-peptide level is used to assess beta-cell function. Patients with type 2 diabetes mellitus (T2DM), who are GADA positive, are labeled latent autoimmune diabetes in adults (LADA).
To characterize patients with T1 and T2DM who have symptoms of gastroparesis using GADA and C-peptide levels and to look for association with the presence of gastroparesis and its symptom severity.
113 T1DM and 90 T2DM patients with symptoms suggestive of gastroparesis were studied. Symptom severity was assessed using Gastroparesis Cardinal Symptom Index (GCSI). Serum samples were analyzed for GADA and C-peptide.
Delayed gastric emptying was present in 91 (81%) of T1DM and 60 (67%) of T2DM patients ( = 0.04). GADA was present in 13% of T2DM subjects [10% in delayed gastric emptying and 20% in normal gastric emptying ( = 0.2)]. Gastric retention and GCSI scores were mostly similar in GADA positive and negative T2DM patients. GADA was present in 45% of T1DM subjects [46% in delayed gastric emptying and 41% in normal gastric emptying ( = 0.81)]. Low C-peptide levels were seen in 79% T1DM patients and 8% T2DM. All seven T2DM patients with low C-peptide were taking insulin compared to 52% of T2DM with normal C-peptide.
GADA was present in 13% while low C-peptide was seen in 8% of our T2DM patients with symptoms of gastroparesis. Neither did correlate with degree of delayed gastric emptying or symptom severity.
NCT01696747.
糖尿病患者发生并发症的风险增加，包括胃轻瘫。1型糖尿病（T1DM）是一种自身免疫性疾病，会导致β细胞功能下降。谷氨酸脱羧酶65抗体（GADA）是评估自身免疫性最常用的检测方法，而C肽水平用于评估β细胞功能。2型糖尿病（T2DM）患者中GADA呈阳性的被标记为成人隐匿性自身免疫性糖尿病（LADA）。
利用GADA和C肽水平对有胃轻瘫症状的T1DM和T2DM患者进行特征描述，并寻找与胃轻瘫的存在及其症状严重程度的关联。
对113例有胃轻瘫症状提示的T1DM患者和90例T2DM患者进行研究。使用胃轻瘫主要症状指数（GCSI）评估症状严重程度。分析血清样本中的GADA和C肽。
91例（81%）T1DM患者和60例（67%）T2DM患者存在胃排空延迟（P = 0.04）。13%的T2DM受试者存在GADA[胃排空延迟者中为10%，胃排空正常者中为20%（P = 0.2）]。GADA阳性和阴性的T2DM患者的胃潴留和GCSI评分大多相似。45%的T1DM受试者存在GADA[胃排空延迟者中为46%，胃排空正常者中为41%（P = 0.81）]。79%的T1DM患者和8%的T2DM患者C肽水平较低。所有7例C肽水平低的T2DM患者都在使用胰岛素，而C肽水平正常的T2DM患者中这一比例为52%。
在我们有胃轻瘫症状的T2DM患者中，13%存在GADA，8%存在低C肽。两者均与胃排空延迟程度或症状严重程度无关。
NCT01696747。
