Ineffective esophageal motility is associated with diabetes mellitus end organ complications.

diabetes mellitus diabetic neuropathy high‐resolution esophageal manometry ineffective esophageal motility

Journal

Neurogastroenterology and motility
ISSN: 1365-2982
Titre abrégé: Neurogastroenterol Motil
Pays: England
ID NLM: 9432572

Informations de publication

Date de publication:
14 Jun 2024
Historique:
revised: 24 04 2024
received: 25 02 2024
accepted: 15 05 2024
medline: 14 6 2024
pubmed: 14 6 2024
entrez: 14 6 2024
Statut: aheadofprint

Résumé

Diabetes Mellitus (DM) is known to induce a wide range of harmful effects on several organs, notably leading to ineffective esophageal motility (IEM). However, the relationship between DM and IEM is not fully elucidated. We aimed to determine the relationship between DM and IEM and to evaluate the impact of DM's end organ complications on IEM severity. A multicenter cohort study of consecutive patients undergoing high-resolution esophageal manometry (HREM) was performed. We reviewed medical records of patients diagnosed with IEM using HREM, encompassing data on demographics, DM history, antidiabetic and other medications as well as comorbidities. Two hundred and forty six subjects met the inclusion criteria. There was no significant difference in any of the HREM parameters between diabetics and nondiabetics. Out of 246 patients, 92 were diabetics. Diabetics with neuropathy presented a significantly lower distal contractile integral (DCI) value compared to those without neuropathy (248.2 ± 226.7 mmHg·cm·sec vs. 375.6 ± 232.4 mmHg·cm·sec; p = 0.02) Similarly, the DCI was lower in diabetics with retinopathy compared to those without retinopathy (199.9 ± 123.1 mmHg·cm·sec vs. 335.4 ± 251.7 mmHg·cm·sec; p = 0.041). Additionally, a significant difference was observed in DCI values among DM patients with ≥2 comorbidities compared to those without comorbidities (224.8 ± 161.0 mmHg·cm·sec vs. 394.2 ± 243.6 mmHg·cm·sec; p = 0.025). Around 12.6% of the variation in DCI could be explained by its linear relationship with hemoglobin A1c (HbA1c), with a regression coefficient (β) of -55.3. DM is significantly associated with IEM in patients with neuropathy, retinopathy, or multiple comorbidities. These results are pivotal for tailoring patient-specific management approaches.

Sections du résumé

BACKGROUND BACKGROUND
Diabetes Mellitus (DM) is known to induce a wide range of harmful effects on several organs, notably leading to ineffective esophageal motility (IEM). However, the relationship between DM and IEM is not fully elucidated. We aimed to determine the relationship between DM and IEM and to evaluate the impact of DM's end organ complications on IEM severity.
METHODS METHODS
A multicenter cohort study of consecutive patients undergoing high-resolution esophageal manometry (HREM) was performed. We reviewed medical records of patients diagnosed with IEM using HREM, encompassing data on demographics, DM history, antidiabetic and other medications as well as comorbidities.
KEY RESULTS RESULTS
Two hundred and forty six subjects met the inclusion criteria. There was no significant difference in any of the HREM parameters between diabetics and nondiabetics. Out of 246 patients, 92 were diabetics. Diabetics with neuropathy presented a significantly lower distal contractile integral (DCI) value compared to those without neuropathy (248.2 ± 226.7 mmHg·cm·sec vs. 375.6 ± 232.4 mmHg·cm·sec; p = 0.02) Similarly, the DCI was lower in diabetics with retinopathy compared to those without retinopathy (199.9 ± 123.1 mmHg·cm·sec vs. 335.4 ± 251.7 mmHg·cm·sec; p = 0.041). Additionally, a significant difference was observed in DCI values among DM patients with ≥2 comorbidities compared to those without comorbidities (224.8 ± 161.0 mmHg·cm·sec vs. 394.2 ± 243.6 mmHg·cm·sec; p = 0.025). Around 12.6% of the variation in DCI could be explained by its linear relationship with hemoglobin A1c (HbA1c), with a regression coefficient (β) of -55.3.
CONCLUSION & INFERENCES CONCLUSIONS
DM is significantly associated with IEM in patients with neuropathy, retinopathy, or multiple comorbidities. These results are pivotal for tailoring patient-specific management approaches.

Identifiants

pubmed: 38873936
doi: 10.1111/nmo.14826
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

e14826

Informations de copyright

© 2024 John Wiley & Sons Ltd.

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Auteurs

Serge Baroud (S)

Division of Gastroenterology and Hepatology, Metro Health Medical Center, The Esophageal and Swallowing Center, Case Western Reserve University, Cleveland, Ohio, USA.

Anthony Kerbage (A)

Department of Internal Medicine, Cleveland Clinic Foundation, Cleveland, Ohio, USA.

Amit Patel (A)

Duke University School of Medicine and the Durham Veterans Affairs Medical Center, Durham, North Carolina, USA.

Anthony Horton (A)

Duke University School of Medicine and the Durham Veterans Affairs Medical Center, Durham, North Carolina, USA.

Ariel Sims (A)

The University of Chicago Medicine, Chicago, Illinois, USA.

Dhyanesh Patel (D)

Vanderbilt University Medical Center, Nashville, Tennessee, USA.

Kurren Mehta (K)

Duke University School of Medicine and the Durham Veterans Affairs Medical Center, Durham, North Carolina, USA.

Neil Kapil (N)

Vanderbilt University Medical Center, Nashville, Tennessee, USA.

Robert Kavitt (R)

The University of Chicago Medicine, Chicago, Illinois, USA.

Vikram Rangan (V)

Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA.

Yue Yu (Y)

Division of Life Sciences and Medicine, Department of Gastroenterology, The First Affiliated Hospital of USTC, University of Science and Technology of China, Hefei, Anhui, China.

Fahmi Shibli (F)

Division of Gastroenterology and Hepatology, Metro Health Medical Center, The Esophageal and Swallowing Center, Case Western Reserve University, Cleveland, Ohio, USA.

Gengqing Song (G)

Division of Gastroenterology and Hepatology, Metro Health Medical Center, The Esophageal and Swallowing Center, Case Western Reserve University, Cleveland, Ohio, USA.

Ronnie Fass (R)

Division of Gastroenterology and Hepatology, Metro Health Medical Center, The Esophageal and Swallowing Center, Case Western Reserve University, Cleveland, Ohio, USA.

Classifications MeSH