Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.
Clinical Prevention Research, Clinical Research, Steno Diabetes Center Copenhagen, Gentofte, Denmark.
Chronobiol Int. 2021 Jun;38(6):801-806. doi: 10.1080/07420528.2021.1890761. Epub 2021 Mar 11.
Colonic contractility normally shows circadian variability regulated by sleep and especially food intake. However, individuals with type 1 diabetes have a reduced or even absent gastrocolic response to a meal, indicating that colonic contractility may be affected by the disease. We hypothesized that individuals with type 1 diabetes and distal symmetric polyneuropathy (DSPN) have decreased motility (expressed as the motility index) and contractility of the colon and a reduced increase in motility index from night to morning compared to healthy controls and individuals with type 1 diabetes without DSPN. Cohorts of 35 individuals with type 1 diabetes and DSPN, 40 individuals with type 1 diabetes without DSPN, and 28 healthy controls were included in this post-hoc, cross-sectional analysis. We investigated, using a wireless motility capsule that measures pH, temperature, and pressure throughout the gastrointestinal tract, whether individuals with type 1 diabetes with and without DSPN, compared to healthy controls, exhibit altered colonic contractility in the evening, night, and morning. Max amplitude, mean peak amplitude, mean contraction, and motility index of the colon were calculated at the afore-designated times. Motility index of the colon tended to be higher in individuals with type 1 diabetes and DSPN compared to controls in the evening ( = .064), but the effect size was small (1.74%). There was no difference in motility index between the groups in the morning or evening. Furthermore, there was no difference in max amplitude, mean peak amplitude, or mean contraction between groups in the morning, evening, and night. As expected, overall contractility increased from night to morning in all groups, but there was no difference between groups in the increase in contractility from night to morning. Colonic contractility generally peaked in the morning, decreased in the evening, and was almost absent at night. Type 1 diabetes and/or DSPN did not impair contractility of the colon at any time point. Contractility and motility increased from morning to night unaffected by type 1 diabetes and/or DSPN.
结肠收缩通常表现出受睡眠和特别是食物摄入调节的昼夜节律变化。然而,1 型糖尿病患者的胃结肠反应减少甚至消失,表明结肠收缩可能受到疾病的影响。我们假设,1 型糖尿病伴远端对称性多发性神经病(DSPN)患者的结肠蠕动(表现为蠕动指数)和收缩力降低,与健康对照组和 1 型糖尿病无 DSPN 患者相比,从夜间到清晨的蠕动指数增加减少。这项回顾性、横断面分析纳入了 35 名 1 型糖尿病伴 DSPN 患者、40 名 1 型糖尿病无 DSPN 患者和 28 名健康对照者。我们使用一种无线动力胶囊,该胶囊可测量整个胃肠道的 pH 值、温度和压力,以检测 1 型糖尿病伴和不伴 DSPN 的个体与健康对照者相比,在傍晚、夜间和清晨结肠收缩力是否发生改变。在预先指定的时间计算结肠的最大振幅、平均峰值振幅、平均收缩和蠕动指数。与对照组相比,1 型糖尿病伴 DSPN 患者在傍晚时的结肠蠕动指数较高( = 0.064),但效应大小较小(1.74%)。在早晨或傍晚,各组之间的蠕动指数没有差异。此外,在早晨、傍晚和夜间,各组之间的最大振幅、平均峰值振幅或平均收缩没有差异。正如预期的那样,所有组的总体收缩力从夜间到清晨增加,但各组之间从夜间到清晨的收缩力增加没有差异。结肠收缩力通常在早晨达到峰值,傍晚时降低,夜间几乎不存在。1 型糖尿病和/或 DSPN 并未在任何时间点损害结肠收缩力。无论是否患有 1 型糖尿病和/或 DSPN,蠕动和收缩力都从早晨增加到夜间。