Correlation between Predictors for Diabetic Gastroparesis and Gastric Emptying Scintigraphy

Kyung-Ju Lee; Kyoung-Ho Ryu; Jin-Ook Chung; Dong-Hyeok Cho; Dong-Jin Chung; Min-Young Chung

doi:10.4068/cmj.2009.45.3.175

Journal List > Chonnam Med J > v.45(3) > 1017922

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Lee, Ryu, Chung, Cho, Chung, and Chung: Correlation between Predictors for Diabetic Gastroparesis and Gastric Emptying Scintigraphy

Original Article

Chonnam Medical Journal

Chonnam Medical Journal 2009; 45(3): 175-181.

Published online: 10 December 2009

DOI: https://doi.org/10.4068/cmj.2009.45.3.175

Correlation between Predictors for Diabetic Gastroparesis and Gastric Emptying Scintigraphy

Kyung-Ju Lee, Kyoung-Ho Ryu, Jin-Ook Chung, Dong-Hyeok Cho, Dong-Jin Chung, Min-Young Chung

Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea.

corresp="yes" Corresponding author (mychung@chonnam.ac.kr)

Accepted 25 November 2009

Abstract

The objective of this study was to evaluate the prevalence of gastroparesis in diabetic patients with severe upper gastrointestinal symptoms and to examine the predictors of diabetic gastroparesis to improve the efficiency of gastric emptying scintigraphy. Gastric emptying of a solid meal (scintigraphy) was measured in 40 patients with diabetes (10 type 1 and 30 type 2) who had severe upper abdominal symptoms. All patients were evaluated for anthropometry, lipid profiles, glycated hemoglobin, cardiac autonomic neuropathy, and other chronic diabetic complications. Of the 40 patients who underwent scintigraphy, the gastric emptying of solids was delayed in 16 (40%) patients, and 24 (60%) patients had cardiac autonomic neuropathy. The BBV cardiac beat-to-beat variability test score correlated positively with the gastric emptying time [OR=6.78 (1.53-30.04), p=0.018]. The deep breathing test (abnormal E/I ratio), one of the BBV tests, correlated positively with the gastric emptying rate of solids [OR=7.00 (1.27-38.36), p=0.025]. However, delayed gastric emptying was not related to the type or duration of diabetes, abdominal symptoms, glycated hemoglobin, body mass index, lipid profiles, or other chronic diabetic complications. Our results suggest that the BBV test, especially the abnormal deep breathing test, is associated with an increased risk of diabetic gastroparesis in diabetic patients with gastrointestinal symptoms.

Keywords: Autonomic nervous system deseases, Diabetic neuropathies, Gastroparesis, Gastric emptying

Figures and Tables

Fig. 1

Correlation between clinical parameters and gastric emptying time.

Table 1

Clinical characteristics of subjects

Values are mean±SD. OHA, oral hypoglycemic agents; HDL, high density lipoprotein; LDL, low density lipoprotein; UAE, urinary albumin excretion.

Table 2

Correlation between cardiovascular reflex tests and gastric emptying time

^*Group with patients presenting delayed gastric emptying time of solids; ^†Group with patients presenting normal gastric emptying time of solids; ^‡BBV: cardiac beat-to-beat variability; Total score of >3 was taken to indicate autonomic neuropathy.

Table 3

Comparison of clinical characteristics between groups with and without diabetic gastroparesis

^*Group with patients presenting delayed gastric emptying time of solids; ^†Group with patients presenting normal gastric emptying time of solids; BMI, body mass index; HDL, high density lipoprotein; LDL, low density lipoprotein; UAE, urinary albumin excretion; BUN, blood urea nitrogen.

Table 4

Predictors for delayed gastric emptying time

Multiple regression analysis, p<0.05. Model includes age, smoking habit, type and duration of diabetes, body mass index, urinary albumin excretion, blood urea nitrogen, LDL-cholesterol, and HDL-cholesterol.

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