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Measures of Autonomic Dysfunction in Diabetic and Idiopathic Gastroparesis

机译:糖尿病和特发性胃轻瘫患者自主神经功能障碍的措施

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Background: Gastroparesis is a condition classically characterized by delayed gastric emptying and is associated with considerable morbidity. While the etiology of gastroparesis remains elusive, autonomic dysfunction may play an important role, especially as many patients with gastroparesis also have diabetes. The aim of this study was to determine whether measures of autonomic function differ between adults with diabetic gastroparesis (DG) and adults with idiopathic gastroparesis (IG).Methods: Tests of systemic autonomic function were performed among 20 adults with GD (six men and 14 women, mean age: 42 years) and 21 adults with IG (seven men and 14 women, mean age: 37 years). Measures included vagal cholinergics by R-R interval percentage variation (RRI-PV) and sympathetic adrenergics by vasoconstriction to cold (VC) and postural adjustment ratio (PAR). The two groups were compared using Wilcoxon rank sum tests and linear regression analysis (STATA 10.0).Results: In univariate analysis, the following autonomic measures differed significantly between DG and IG: VC (P = 0.004), PAR (P = 0.045), VC + PAR (P = 0.002) and RRI-PV (P < 0.001). In multivariate analysis (P = 0.002, R2 = 0.55), only RRI-PV (adjusted odds ratio (aOR): 1.02, 95% confidence interval (CI): 1.01 - 1.03) differed significantly between DG and IG patients.Conclusions: Vagal cholinergics are affected to a greater degree in DG compared to IG, suggesting that impaired vagal tone is not a universal mechanism for gastroparesis.Gastroenterol Res. 2016;9(4-5):65-69doi: http://dx.doi.org/10.14740/gr713w
机译:背景:胃轻瘫是典型的以胃排空延迟为特征的疾病,并与相当高的发病率有关。尽管胃轻瘫的病因仍然难以捉摸,但自主神经功能障碍可能起着重要作用,特别是因为许多胃轻瘫的患者也患有糖尿病。这项研究的目的是确定在患有糖尿病性胃轻瘫(DG)的成年人和患有特发性胃轻瘫(IG)的成年人中,自主神经功能的测量方法是否有所不同。方法:在20名GD成年人(6名男性和14名男性)中进行了系统的自主神经功能测试女性,平均年龄:42岁)和21位患有IG的成年人(7位男性和14位女性,平均年龄:37岁)。措施包括通过R-R间隔百分比变化(RRI-PV)进行的迷走胆碱能药和通过冷缩血管收缩(VC)和体位调节比(PAR)进行的交感神经性肾上腺素能。使用Wilcoxon秩和检验和线性回归分析(STATA 10.0)对两组进行比较。结果:在单变量分析中,DG和IG之间的以下自主性测量值有显着差异:VC(P = 0.004),PAR(P = 0.045), VC + PAR(P = 0.002)和RRI-PV(P <0.001)。在多变量分析中(P = 0.002,R2 = 0.55),DG和IG患者之间只有RRI-PV(校正比值比(aOR):1.02,95%置信区间(CI):1.01-1.03)有显着差异。与IG相比,胆碱能药对DG的影响更大,这表明迷走神经张力受损不是胃轻瘫的普遍机制。 2016; 9(4-5):65-69doi:http://dx.doi.org/10.14740/gr713w

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