Division of Gastroenterology and Hepatology, Clinical Enteric Neuroscience Translational and Epidemiological Research Program, Mayo Clinic, Rochester, MN, USA.
Division of Biostatistics, Mayo Clinic, Rochester, MN, USA.
Neurogastroenterol Motil. 2021 Dec;33(12):e14154. doi: 10.1111/nmo.14154. Epub 2021 Apr 8.
Gastric emptying is of limited utility for predicting the severity of symptoms in patients with diabetes mellitus and gastrointestinal symptoms. We evaluated the extent to which symptoms recorded during a C-spirulina-based gastric emptying breath test (GEBT) or scintigraphy predicting the severity of daily symptoms in diabetes mellitus.
Gastric emptying, symptoms during a gastric emptying study, either scintigraphy (n = 38) or GEBT (n = 111), and daily gastrointestinal symptoms were evaluated in 149 patients with diabetes mellitus and variably severe gastrointestinal symptoms.
Gastric emptying was normal, delayed, and rapid in 37%, 52%, and 9% measured with the GEBT and 55%, 34%, and 11% of patients measured with scintigraphy; differences between GEBT and scintigraphy were not significant. Daily symptoms were moderately severe or more intense in 58% and 21% of patients undergoing scintigraphy and GEBT (P < 0.0001). Symptoms during the GEBT (46%) and emptying t (3%) explained 50% of the variance in daily symptoms in the GEBT group. In the scintigraphy group, symptoms explained 29% of this variance; the t was insignificant. Patients who reported that one or more symptoms were more severe than the others during the GE study were more likely (OR 3.98, 95% CI 2.16, 7.33) to report the same symptom(s) as being the most severe in the daily diary.
Symptoms during a GEBT and to a lesser extent during scintigraphy, but not gastric emptying predict the severity of daily symptoms and may serve as a biomarker in patients with diabetes mellitus.
胃排空对于预测糖尿病伴胃肠道症状患者症状的严重程度作用有限。我们评估了基于 C-螺旋藻的胃排空呼气试验(GEBT)或闪烁扫描记录的症状在多大程度上预测糖尿病患者的日常症状严重程度。
149 例糖尿病伴不同严重程度胃肠道症状患者进行胃排空、胃排空研究期间的症状(闪烁扫描[n=38]或 GEBT[n=111])和每日胃肠道症状评估。
GEBT 测量的胃排空正常、延迟和快速分别为 37%、52%和 9%,闪烁扫描分别为 55%、34%和 11%;GEBT 和闪烁扫描之间的差异无统计学意义。接受闪烁扫描和 GEBT 的患者中,每日症状中度或更严重的分别为 58%和 21%(P<0.0001)。GEBT 期间的症状(46%)和 t 值(3%)解释了 GEBT 组中 50%的每日症状方差。在闪烁扫描组中,症状解释了这一方差的 29%;t 值无统计学意义。在 GE 研究期间报告一个或多个症状比其他症状更严重的患者更有可能(OR 3.98,95%CI 2.16,7.33)在日常日记中报告相同的症状(s)为最严重的症状。
GEBT 期间的症状(在一定程度上闪烁扫描期间的症状),但不是胃排空,可预测日常症状的严重程度,可作为糖尿病患者的生物标志物。