Yan Juan, Sun Xiaoying, Liu Xiaoyan, Li Xiaoming
Department of Ultrasound Diagnosis, The Second Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China.
Department of Ultrasound, Jinan First People's Hospital, Jinan, Shandong, China.
J Diabetes Investig. 2025 Aug;16(8):1518-1525. doi: 10.1111/jdi.70059. Epub 2025 May 19.
This study evaluates gastrointestinal motility dysfunction in type 2 diabetes patients with and without neuropathy compared to healthy individuals using gastric filling ultrasound.
We enrolled 210 participants: 50 healthy controls, 106 diabetic controls (without neuropathy), and 54 observation patients (with neuropathy). Gastric emptying times and fullness scores were measured at 30 and 60 min post-meal. Small intestinal transit rates were assessed at baseline and 60 min. Gastric capacity and wall thickness were evaluated by ultrasound, while motilin and glucagon levels were measured by ELISA.
The observation group showed significantly prolonged gastric emptying vs both control groups (30 min: 75.38 ± 13.49 vs 52.46 ± 11.37 vs 45.96 ± 12.85 min; 60 min: 122.53 ± 16.38 vs 84.27 ± 11.44 vs 75.12 ± 10.20 min; all P < 0.001). Gastric fullness scores exhibited similar progressive increases (30 min: 7.45 ± 0.66 vs 5.37 ± 0.75 vs 4.53 ± 0.69; 60 min: 6.84 ± 0.51 vs 4.56 ± 0.68 vs 3.72 ± 0.51; P < 0.001). Small intestinal transit was slowest in the observation group (baseline: 3.62 ± 0.21 vs 4.53 ± 0.36 vs 5.36 ± 0.25 cm/min; 60 min: 3.05 ± 0.15 vs 4.15 ± 0.50 vs 5.25 ± 0.31 cm/min; P < 0.05). The observation group had significantly reduced gastric capacity (714.68 ± 35.49 vs 875.25 ± 53.66 vs 923.63 ± 39.72 mL) and increased wall thickness (4.16 ± 0.55 vs 3.33 ± 0.42 vs 2.98 ± 0.26 cm) vs other groups (P < 0.001). Hormonal changes included lower motilin (28.44 ± 5.16 vs 45.67 ± 7.33 vs 53.71 ± 8.65 pg/mL) and higher glucagon (382.56 ± 23.62 vs 295.14 ± 11.55 vs 256.86 ± 27.90 pg/mL) in the observation group (P < 0.001).
Gastric filling ultrasound demonstrates progressive gastrointestinal impairment from healthy individuals to diabetic patients, with the most severe dysfunction in neuropathic cases. These objective measures support regular gastrointestinal assessment in diabetes management, particularly for patients developing neuropathy.
本研究采用胃充盈超声评估2型糖尿病伴或不伴神经病变患者与健康个体相比的胃肠动力功能障碍。
我们招募了210名参与者：50名健康对照者、106名糖尿病对照者（无神经病变）和54名观察组患者（有神经病变）。在餐后30分钟和60分钟测量胃排空时间和饱腹感评分。在基线和60分钟时评估小肠转运率。通过超声评估胃容量和胃壁厚度，同时通过酶联免疫吸附测定法测量胃动素和胰高血糖素水平。
观察组与两个对照组相比，胃排空明显延长（30分钟：75.38±13.49 vs 52.46±11.37 vs 45.96±12.85分钟；60分钟：122.53±16.38 vs 84.27±11.44 vs 75.12±10.20分钟；所有P<0.001）。胃饱腹感评分呈现相似的逐渐增加趋势（30分钟：7.45±0.66 vs 5.37±0.75 vs 4.53±0.69；60分钟：6.84±0.51 vs 4.56±0.68 vs 3.72±0.51；P<0.001）。观察组小肠转运最慢（基线：3.62±0.21 vs 4.53±0.36 vs 5.36±0.25厘米/分钟；60分钟：3.05±0.15 vs 4.15±0.50 vs 5.25±0.31厘米/分钟；P<0.05）。与其他组相比，观察组胃容量显著降低（714.68±35.49 vs 875.25±53.66 vs 923.63±39.72毫升），胃壁厚度增加（4.16±0.55 vs 3.33±0.42 vs 2.98±0.26厘米）（P<0.001）。激素变化包括观察组胃动素较低（28.44±5.16 vs 45.67±7.33 vs 53.71±8.65皮克/毫升）和胰高血糖素较高（382.56±23.62 vs 295.14±11.55 vs 256.86±27.90皮克/毫升）（P<0.001）。
胃充盈超声显示从健康个体到糖尿病患者存在逐渐进展的胃肠功能损害，神经病变患者功能障碍最为严重。这些客观指标支持在糖尿病管理中定期进行胃肠评估，尤其是对于发生神经病变的患者。
