Munteanu Sabrina-Nicoleta, Huțanu Dragoș, Filip Ana-Maria, Cozac-Szőke Andreea Raluca, Mocan Simona, Negovan Anca
Department of Clinical Science-Internal Medicine, "George Emil Palade" University of Medicine, Pharmacy, Science, and Technology of Târgu Mureș, 540139 Mureș, Romania.
Pulmonology Department, Mureș County Clinical Hospital, Târgu Mureș, 540011 Mureș, Romania.
Life (Basel). 2024 Sep 13;14(9):1160. doi: 10.3390/life14091160.
Type 2 diabetes mellitus (T2DM) affects up to 10% of adults globally, and its complications can mask the risk of gastrointestinal bleeding or malignancy.
Our study enrolled 633 endoscopic patients stratified according to T2DM presence (4:1 ratio in favor of the control group).
T2DM patients referred for endoscopy experienced lower prevalence of epigastric pain and heartburn (OR = 0.637/OR = 0.346, < 0.05). Often being anemic (OR = 2.23, < 0.001), they had significantly lower hemoglobin ( = 0.001) and serum iron ( = 0.02), but serum cholesterol was higher in non-diabetics. Ulcers, erosions and mucosal hemorrhages were comparable between groups ( < 0.05), although low-dose aspirin use was more prevalent in diabetics ( = 0.000, OR = 2.34). T2DM was associated with the increased frequency of antro-corporal active gastritis (OR = 1.451/OR 1.501), with smokers presenting a higher frequency of active infection (OR = 3.37). T2DM predicted anemia (adjusted OR = 1.70) and the absence of gastroesophageal reflux symptoms (adjusted OR = 0.37), but not active gastritis or premalignant lesions.
In an endoscopic population, patients with T2DM had lower hemoglobin and serum iron levels. There was an inverse correlation between T2DM and heartburn. gastritis and premalignant lesions occurred more frequently in diabetic patients (predominantly pangastritis) before adjusting for age or associated comorbidities, with smoking increasing the risk for active infection.
2型糖尿病（T2DM）全球影响着高达10%的成年人，其并发症可能掩盖胃肠道出血或恶性肿瘤的风险。
我们的研究纳入了633例根据是否存在T2DM分层的内镜检查患者（对照组与T2DM组比例为4:1）。
因内镜检查就诊的T2DM患者上腹部疼痛和烧心的患病率较低（OR = 0.637/OR = 0.346，P < 0.05）。他们常伴有贫血（OR = 2.23，P < 0.001），血红蛋白（P = 0.001）和血清铁（P = 0.02）显著较低，但非糖尿病患者的血清胆固醇较高。两组之间溃疡、糜烂和黏膜出血情况相当（P < 0.05），尽管低剂量阿司匹林在糖尿病患者中使用更为普遍（P = 0.000，OR = 2.34）。T2DM与胃体-胃窦部活动性胃炎的发生率增加相关（OR = 1.451/OR 1.501），吸烟者活动性幽门螺杆菌感染的发生率更高（OR = 3.37）。T2DM可预测贫血（校正OR = 1.70）和无胃食管反流症状（校正OR = 0.37），但不能预测活动性幽门螺杆菌胃炎或癌前病变。
在内镜检查人群中，T2DM患者的血红蛋白和血清铁水平较低。T2DM与烧心呈负相关。在调整年龄或相关合并症之前，糖尿病患者胃炎和癌前病变（主要是全胃炎）的发生率更高，吸烟会增加活动性幽门螺杆菌感染的风险。
