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Ultrasonographic comparison of gastric motility between diabetic gastroparesis patients with and without metabolic syndrome
Authors:Masahiro Sogabe  Yoshitaka Kimura  Hiroshi Iwaki  Yoshio Okita  Shingo Hibino  Seizo Sawda  Toshiya Okahisa  Koichi Okamoto  Koji Tsujigami  Hiroshige Hayashi  Yasuo Hukui  Toshio Nakamura  Toshikatsu Taniki  Masahiko Nakasono  Naoki Muguruma  Seisuke Okamura   Susumu Ito
Affiliation:Department of Digestive and Cardiovascular Medicine, Institute of Health Biosciences, the University of Tokushima Graduate School,;Department of Internal Medicine, Anan Central Hospital of the Medical Association,;Department of Internal Medicine, Hibino Hospital, Tokushima,;Department of Gastroenterology, National Hospital Organization Zentsuji National Hospital, Kagawa,;Department of Gastroenterology, Fukuda Clinic of Internal Medicine Heart and Digestive, and;Surgery, Kochi Health Sciences Center, Kochi, Japan
Abstract:Background and Aims:  Diabetic patients with poor glycemic control or long standing disease often have impaired gastric motility. Recently, metabolic factors such as blood glucose have been reported as influencing gastric motility independently of autonomic neuropathy. Many diabetic patients have metabolic syndrome, which is strongly associated with coronary and other diseases. We investigated whether metabolic syndrome influences diabetic gastroparesis patients.
Methods:  We observed gastric motility ultrasonographically in diabetic gastroparesis patients including nine with and nine without metabolic syndrome. Both groups complained of upper abdominal symptoms when hospitalized to improve blood sugar control. All patients underwent upper gastrointestinal endoscopy to rule out gastric and duodenal lesions. All had autonomic neuropathy. Gastric motility was evaluated within 3 days after admission by transabdominal ultrasonography after a test meal.
Results:  Gastric emptying was 45.0 ± 13.7% in patients with and 39.1 ± 11.9% in patients without metabolic syndrome, which was not statistically significant. Frequency of gastric contractions was 8.33 ± 2.78 per 3 min in patients with metabolic syndrome and 7.44 ± 2.13 per 3 min in the others, which was not statistically significant. The motility index, which involves antral contractility, was 3.21 ± 2.18 in patients with metabolic syndrome and 2.80 ± 1.87 in the others, which was not statistically significant.
Conclusions:  Metabolic syndrome did not appear to contribute to delayed gastric motility in diabetic gastroparesis.
Keywords:autonomic neuropathy    diabetic gastroparesis    gastric emptying    metabolic syndrome    motility index
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