Section Of Gastroenterology, Wake Forest University, Winston-Salem, NC, USA.
Section of Gastroenterology, Temple University, Philadelphia, PA, USA.
Dig Dis Sci. 2024 Aug;69(8):2904-2915. doi: 10.1007/s10620-024-08520-8. Epub 2024 Jun 14.
Patients with gastroparesis (Gp) often have diets deficient in calories, electrolytes, and vitamins. Vitamin D levels have been reported to be low in some patients with Gp but has not been systematically studied.
To determine vitamin D levels and relationships among symptoms, gastric emptying and gastric myoelectrical activity (GMA) in patients with symptoms of Gp.
25-hydroxy-vitamin D was measured in patients at enrollment in the Gastroparesis Clinical Consortium Registry. Gastroparesis Cardinal Symptoms Index (GCSI), gastric emptying, and GMA before and after water load satiety test (WLST) were measured. GMA, expressed as percentage distribution of activity in normal and dysrhythmic ranges, was recorded using electrogastrography.
Overall, vitamin D levels were low (< 30 ng/ml) in 288 of 513 (56.1%) patients with symptoms of Gp (206 of 376 (54.8%) patients with delayed gastric emptying (Gp) and 82 of 137 (59.9%) patients with symptoms of Gp and normal gastric emptying). Low vitamin D levels were associated with increased nausea and vomiting (P < 0.0001), but not with fullness or bloating subscores. Low vitamin D levels in patients with Gp were associated with greater meal retention at four hours (36% retention) compared with Gp patients with normal vitamin D levels (31% retention; P = 0.05). Low vitamin D in patients with normal gastric emptying was associated with decreased normal 3 cpm GMA before (P = 0.001) and increased tachygastria after WLST (P = 0.01).
Low vitamin D levels are present in half the patients with symptoms of gastroparesis and are associated with nausea and vomiting and gastric neuromuscular dysfunction.
确定胃轻瘫(Gp)患者的维生素 D 水平及其与症状、胃排空和胃电活动(GMA)之间的关系。
在 Gastroparesis Clinical Consortium Registry 登记时测量患者的 25-羟维生素 D。测量胃轻瘫临床症状指数(GCSI)、胃排空以及水负荷饱腹感试验(WLST)前后的 GMA。使用胃电图记录 GMA,用正常和心律失常范围内的活动百分比分布表示。
总体而言,513 例有 Gp 症状的患者中有 288 例(56.1%)维生素 D 水平较低(376 例有延迟胃排空的 Gp 患者中有 206 例(54.8%)和 137 例有 Gp 症状且胃排空正常的患者中有 82 例(59.9%))。低维生素 D 水平与恶心和呕吐增加相关(P<0.0001),但与饱胀或腹胀评分无关。Gp 患者中维生素 D 水平低与 4 小时时餐食潴留更多(36%潴留)相关,而维生素 D 水平正常的 Gp 患者餐食潴留较少(31%潴留;P=0.05)。胃排空正常的患者中维生素 D 水平低与 WLST 前正常 3 cpm GMA 减少(P=0.001)和 WLST 后快波增加(P=0.01)相关。
有 Gp 症状的患者中约一半存在低维生素 D 水平,与恶心和呕吐以及胃神经肌肉功能障碍相关。