Merio R, Festa A, Bergmann H, Eder T, Eibl N, Stacher-Janotta G, Weber U, Budka C, Heckenberg A, Bauer P, Francesconi M, Schernthaner G, Stacher G
Department of Surgery, University of Vienna, Austria.
Diabetes Care. 1997 Mar;20(3):419-23. doi: 10.2337/diacare.20.3.419.
To investigate whether autonomic neuropathy or hyperglycemia plays a crucial etiological role in gastric retention of ingesta frequently found in type I diabetic patients.
We investigated the gastric emptying of a radiolabeled semisolid 1,168 kJ meal in 38 female and 45 male patients (age 18-75 years; illness duration 3-46 years). None took drugs affecting gastrointestinal motility. Fasted patients underwent tests of cardiovascular autonomic and peripheral nerve function. Blood glucose levels were determined before and after the scintigraphic recording of gastric emptying.
The percentage of meal remaining in the stomach at the end of the 50-min recording time was related significantly to the patients' degree of cardiovascular autonomic neuropathy [r (81) = 0.235, P < 0.028] but not to their degree of peripheral neuropathy, preprandial blood glucose level, HbA1c indicative of glycemic control, diabetes duration, and age. The patients' mean residual percentage of meal was significantly greater than that of 48 healthy subjects, that is, 71.1 +/- 15.1 vs. 53.5 +/- 13.1% [means +/- SD; t (129) = 6.48, P < 0.0001]. The healthy individuals' mean residual percentage + 2 SD was exceeded in 22 patients.
Slow gastric emptying in patients with type I diabetes seems related to the degree of autonomic neuropathy but not to peripheral neuropathy, actual blood glucose, and glycemic control.
研究自主神经病变或高血糖在Ⅰ型糖尿病患者常见的胃内容物潴留病因中是否起关键作用。
我们调查了38名女性和45名男性患者（年龄18 - 75岁；病程3 - 46年）对含放射性标记的1168千焦半固体餐的胃排空情况。无人服用影响胃肠动力的药物。空腹患者接受了心血管自主神经和周围神经功能测试。在胃排空闪烁扫描记录前后测定血糖水平。
在50分钟记录时间结束时胃内残留餐食的百分比与患者心血管自主神经病变程度显著相关[r(81)=0.235，P<0.028]，但与周围神经病变程度、餐前血糖水平、反映血糖控制情况的糖化血红蛋白、糖尿病病程及年龄无关。患者餐食平均残留百分比显著高于48名健康受试者，即71.1±15.1%对53.5±13.1%[均值±标准差；t(129)=6.48，P<0.0001]。22名患者超过了健康个体平均残留百分比+2标准差。
Ⅰ型糖尿病患者胃排空缓慢似乎与自主神经病变程度有关，而与周围神经病变、实际血糖及血糖控制无关。
