Undeland K A, Hausken T, Aanderud S, Berstad A
Medical Department, Haukeland University Hospital, Bergen, Norway.
Neurogastroenterol Motil. 1997 Mar;9(1):19-24. doi: 10.1046/j.1365-2982.1997.d01-3.x.
Poor relaxation in the stomach after a meal may contribute to disturbed gastric emptying and abdominal discomfort in patients with diabetes mellitus. In this study we aimed to compare barostat-recorded postprandial volume responses in these patients to those in healthy controls, and to study the relationship between the proximal volume responses, antral filling and vagal neuropathy. We compared 14 consecutively recruited patients with type 1 diabetes mellitus (DM) to 18 healthy controls (HC) with respect to meal-induced gastric volume response assessed by a barostat, antral area recorded by ultrasound, and vagal tone assessed by respiratory sinus arrhythmia (RSA). Meal-induced volume response of the proximal stomach (area under time-volume curve 0-30 min) was significantly (P = 0.04) lower in DM than in HC, 49.4 min.mL +/- 60.7 vs. 114.9 min.mL +/- 100.8. Antral area was significantly larger in DM than in HC, both fasting (4.3 cm2 +/- 1.9 vs. 3.0 cm2 +/- 0.9) and 10 min after ingestion of meat soup (11.8 cm2 +/- 3.4 vs. 8.8 cm2 +/- 2.9), P = 0.03 and P = 0.02, respectively. Vagal tone was significantly (P = 0.01) lower in DM than in HC. 3.7 beats min-1 +/- 2.3 vs. 6.1 beats min-1 +/- 2.2. No significant correlation was observed between the proximal volume responses and antral widening. Maximal gastric volume response correlated significantly with vagal tone (r = 0.77, P = 0.002).
patients with diabetes mellitus type 1 have impaired meal-induced volume response, possibly as a consequence of reduced vagal tone.
糖尿病患者餐后胃松弛不良可能导致胃排空障碍和腹部不适。在本研究中，我们旨在比较通过压力传感器记录的这些患者与健康对照者的餐后容量反应，并研究近端容量反应、胃窦充盈和迷走神经病变之间的关系。我们比较了14例连续招募的1型糖尿病（DM）患者与18例健康对照者（HC），通过压力传感器评估进餐引起的胃容量反应、超声记录胃窦面积以及通过呼吸性窦性心律不齐（RSA）评估迷走神经张力。DM患者近端胃的进餐引起的容量反应（0 - 30分钟时间 - 容量曲线下面积）显著低于HC（P = 0.04），分别为49.4分钟·毫升±60.7与114.9分钟·毫升±100.8。DM患者的胃窦面积在空腹时（4.3平方厘米±1.9与3.0平方厘米±0.9）以及摄入肉汤10分钟后（11.8平方厘米±3.4与8.8平方厘米±2.9）均显著大于HC，P值分别为0.03和0.02。DM患者的迷走神经张力显著低于HC（P = 0.01），分别为3.7次/分钟±2.3与6.1次/分钟±2.2。未观察到近端容量反应与胃窦增宽之间存在显著相关性。最大胃容量反应与迷走神经张力显著相关（r = 0.77，P = 0.002）。
1型糖尿病患者进餐引起的容量反应受损，可能是迷走神经张力降低的结果。
