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Keywords:

  • autonomic neuropathy;
  • gastric emptying;
  • microalbuminuria;
  • type1 diabetes mellitus
  • 自主神经病变,胃排空,微量白蛋白尿,1型糖尿病

Abstract

Background

The aims of the present study were to determine the frequency of delayed gastric emptying in children and adolescents with type 1 diabetes mellitus (T1DM) and to investigate the relationship between gastric emptying rate and other contributing factors (e.g. serum HbA1c, duration of diabetes and microalbuminuria) in these patients.

Methods

This was a clinical trial evaluating the rate of gastric emptying of solid meals in 33 children and adolescents with T1DM and in 26 healthy peers using a radionuclide method. Three consecutive overnight urine collections were used to calculate the albumin excretion rate.

Results

There was no significant difference in the gastric half-emptying time (GE t½) between patients and controls (151.7 ± 154.5 vs 109.8 ± 60.5 min, respectively; P = 0.885) or the frequency of delayed gastric emptying (36.4% vs 30.8%, respectively; P = 0.433). There was a moderately positive correlation between GE t½ and the duration of diabetes (r = 0.380; P = 0.029). There was no correlation between GE t½ and microalbumin levels in T1DM patients. In these patients, the body mass index standard deviation scores were significantly lower than in patients with normal gastric emptying (–0.13 ± 0.87 vs 0.7 ± 1.23, respectively; P = 0.044).

Conclusion

Progression of delayed gastric emptying is more likely to be related to a longer duration of diabetes than glycemic control in children and adolescents with T1DM. Patients with delayed gastric emptying are thinner compared with patients with a normal rate of gastric emptying; they may also be asymptomatic.

摘要

背景

本研究的目的是在儿童与青少年1型糖尿病(T1DM)患者中调查胃排空延迟的发生率,并且在这些患者中研究胃排空速度与其他危险因素(例如血清HbA1c、糖尿病病程以及微量白蛋白尿)之间的相关性。

方法

这是一项在33名儿童与青少年T1DM患者以及26名健康配对者中进行的临床试验,使用放射性核素方法来评估固体食物的胃排空速度。连续3天收集隔夜尿来计算白蛋白排泄率。

结果

在患者与对照者之间,胃排空一半的时间(GE t1⁄2)(151.7±154.5分钟 vs 109.8±60.5分钟;P = 0.885)以及胃排空延迟的发生率(36.4% vs 30.8%;P = 0.433)都没有显著性的差异。GE t1⁄2与糖尿病病程之间有中度的正相关关系(r = 0.380;P = 0.029)。在T1DM患者中GE t1⁄2与微量白蛋白尿水平之间没有相关性。与胃排空正常的患者相比较,胃排空延迟患者的体重指数标准差分数明显更低(–0.13±0.87 vs 0.7±1.23;P = 0.044)。

结论

在儿童与青少年T1DM患者中,与血糖控制情况相比较,胃排空延迟的进展更有可能与较长的糖尿病病程相关。与胃排空速度正常的患者相比较,胃排空延迟的患者更瘦;他们也可能毫无症状。