Relationship between esophageal dysfunction and neuropathy in diabetic patients

Kinekawa, Fumihiko; Kubo, Fumiyoshi; Matsuda, Kazuya; Fujita, Youko; Tomita, Tadataka; Uchida, Yuzo; Nishioka, Mikio

doi:10.1111/j.1572-0241.2001.03862.x

Cited by 59 publications

(41 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…CV R-R is a simple index of diabetic autonomic neuropathy, in particular of vagal neuropathy, and a CV R-R value of 2% has been recognized as a critical level for vagal neuropathy [31,32]. The vagal nerve conveys ghrelin-mediated signals for GH secretion and food intake from the stomach to the brain [33].…”

Section: Discussionmentioning

confidence: 99%

Plasma Ghrelin Concentrations in Different Clinical Stages of Diabetic Complications and Glycemic Control in Japanese Diabetics

et al. 2007

View full text Add to dashboard Cite

Abstract. Ghrelin is an acylated 28-amino-acid peptide that stimulates food intake, GH secretion, and gastric motility. Experimental studies have suggested that ghrelin plays roles in glucose homeostasis, atherosclerosis, and microangiopathy. We investigated possible involvement of ghrelin in micro-and macro-vascular diabetic complications and glycemic control in diabetic patients. Fasting and postprandial plasma ghrelin concentrations after a test meal were measured in 108 and 61 Japanese diabetic patients, respectively. Plasma ghrelin concentrations were negatively correlated with body mass index (BMI) (r = -0.309, P = 0.002) or HbA 1c (r = -0.264, P = 0.0065). Plasma ghrelin levels in patients with diabetic nephropathy who showed high serum creatinine levels (s-Cre) were significantly higher than those in patients who showed normal s-Cre (P<0.02). In patients with diabetic triopathy, plasma ghrelin concentrations were significantly lower than those in patients without diabetic complications (P<0.05). Stepwise multiple regression analyses revealed that s-Cre, BMI, and HbA 1c were independently associated with plasma ghrelin levels. A postprandial decrease of ghrelin was observed in patients with normal CV R-R values or those with normal body weight, whereas it was not seen in obese patients or in patients with low CV R-R values. Suppression rates of ghrelin 30-60 min after a test meal in obese patients were significantly lower than those in normal-weight patients. These findings suggest that ghrelin secretion is suppressed by long-term hyperglycemia and that obesity influences the regulation of ghrelin secretion.

show abstract

Section: Discussionmentioning

confidence: 99%

Plasma Ghrelin Concentrations in Different Clinical Stages of Diabetic Complications and Glycemic Control in Japanese Diabetics

et al. 2007

View full text Add to dashboard Cite

show abstract

“…Several studies showed that disease duration of diabetes [117,120] and the presence of diabetic neuropathy [119,120] were associated with GERD. Because esophageal motility disorder and abnormal acid reflux in diabetic patients are associated with diabetic motor neuropathy [122] and such esophageal dysfunction is worsened with long disease duration [123], esophageal dysfunction may result in a higher prevalence of GERD in diabetic patients.…”

Section: Diabetes Mellitusmentioning

confidence: 99%

Epidemiology and clinical characteristics of GERD in the Japanese population

2009

View full text Add to dashboard Cite

We reviewed articles on the epidemiology and clinical characteristics of gastroesophageal reflux disease (GERD) in Japan to clarify these features of GERD in this country. Although the definition of GERD depends on the individual study, the prevalence of GERD has been increasing since the end of the 1990s. The reasons for the increase in the prevalence of GERD may be due to increases in gastric acid secretion, a decrease in the Helicobacter pylori infection rate, more attention being paid to GERD, and advances in the concept of GERD. More than half of GERD patients had non-erosive reflux disease, and the majority (87%) of erosive esophagitis was mild type, such as Los Angeles classification grade A and grade B. There were several identified risk factors, such as older age, obesity, and hiatal hernia. In particular, mild gastric atrophy and absence of H. pylori infection influence the characteristics of GERD in the Japanese population. We also discuss GERD in the elderly; asymptomatic GERD; the natural history of GERD; and associations between GERD and peptic ulcer disease and H. pylori eradication. We examined the prevalence of GERD in patients with specific diseases, and found a higher prevalence of GERD, compared with that in the general population, in patients with diabetes mellitus, those with obstructive sleep apnea syndrome, and those with bronchial asthma. We provide a comprehensive review of GERD in the Japanese population and raise several clinical issues.

show abstract

“…2 In our study, esophageal dysfunction was unexpectedly found to be related to motor nerve conduction velocity rather than the coeffi cient of variation of R-R intervals, although the pathophysiology of esophageal dysfunction was largely caused by autonomic neuropathy. 2 It may be hard to predict esophageal dysfunction in patients with diabetes screened for autonomic neuropathy based solely on cardiac dysfunction because the degree of vagal disorder varies by organ in patients with diabetes. [3][4][5][6] There are many opinions on the relationship between obesity and GERD; for example, obesity is a risk factor for GERD.…”

Section: Authors' Replymentioning

confidence: 52%