Gastroparesis, Gastric Dysrhythmias, and Dyspepsia Symptoms in Type 2 Diabetes

2 型糖尿病的胃轻瘫、胃节律失常和消化不良症状

• 批准号: 7615734
• 负责人: KENNETH L KOCH
• 金额: $ 34.38万
• 依托单位: WAKE FOREST UNIVERSITY HEALTH SCIENCES
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-04-15 至 2011-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7615734
• 关键词: Abdomen; Acute; Biological Assay; Cholecystokinin; Communities; Data; Databases; Dyspepsia; Enrollment; Epidemic; Functional disorder; Gastric Emptying; Gastroparesis; Glucose; Glycosylated hemoglobin A; Hormones; Hyperglycemia; Laboratories; Longitudinal Studies; Measures; Nausea; Non-Insulin-Dependent Diabetes Mellitus; Patients; Phase; Physiological; Population; Prevalence; Questionnaires; Research; Research Design; Role; Siblings; Solid; Stomach; Symptoms; Testing; Time; United States; United States National Institutes of Health; Vasopressins; Water; blood glucose regulation; cell motility; demographics; diabetic; ghrelin; insight; motility disorder; neuromuscular; population based; response; stomach motility; treatment effect

DESCRIPTION (provided by applicant): Type 2 diabetes mellitus (T2DM) afflicts 14 million patients; many patients have undiagnosed gastroparesis (GP) and suffer from nausea, bloating, and abdominal discomfort. Broad objectives of this study are to: 1) determine the prevalence and heritable components of gastric motility abnormalities (e.g. GP, gastric dysrhythmias) and dyspepsia-like symptoms in sibling pairs with T2DM; 2) investigate mechanisms of dyspepsia symptoms and gastric motility dysfunction during acute provocative test meals; and 3) determine the effect of treatment of hyperglycemia on dyspepsia symptoms and gastric motility disorders. Specific aims are: 1) to determine the prevalence of dyspepsia symptoms, GP, and gastric dysrhythmias in a large, well- characterized, community-based population of sibling pairs with T2DM currently enrolled in an NIH sponsored study; 2) to correlate demographics, symptoms, laboratory results, gastric motility test data, and hereditable components in sibling pairs with T2DM with and without GP; 3) to investigate mechanisms of GP and dyspepsia symptoms by measuring gastric myoelectrical activity and selected hormones (e.g., ghrelin, cholecystokinin, and vasopressin) in response to provocative test meals; and 4) to determine the effect of aggressive glucose control on dyspepsia symptoms and gastric motility function. Research design incorporates the recruitment of 200 sibling pairs from a data base of 1200 well-characterized T2DM patients. Symptom questionnaires, solid-phase gastric emptying studies and electrogastrogram recordings with provocative test meal will be completed over the 5 year period (Long-Term Study). Results from these studies will determine the prevalence of gastropathies and dyspepsia symptoms in a comprehensive study of a large population with T2DM. A subset of T2DM patients with and without GP will undergo non-invasive physiologic testing and hormone assays during a provocative water load test and a caloric meal test. Results of these studies will provide new insights into postprandial symptoms in patients with T2DM with and without GP. In the Short-Term Study, patients with GP and HbA1c >8 will be treated aggressively to obtain normal glucose levels and HbA1c levels during a 6 month time period and compared with T2DM patients with normal gastric emptying and HbA1C <8. Electrogastrogram testing with non-caloric and caloric meal tests will be repeated after 3 and 6 months and solid-phase gastric emptying tests after 6 months of therapy. Results from the Short-Term Study will indicate the relevance of hyperglycemia on symptoms, gastric dysrhythmias, and GP in patients with T2DM. There is an epidemic of T2DM in the United States and many patients have unrecognized stomach motility disorders. The proposed research will determine prevalence of the "diabetic stomach" in patients with T2DM, investigate mechanisms of dyspepsia symptoms and stomach neuromuscular dysfunction, and evaluate the role of hyperglycemia in stomach motility dysfunction

描述（由申请人提供）： 2型糖尿病（T2DM）折磨1400万患者；许多患者没有诊断出胃轻瘫（GP），并且患有恶心，腹胀和腹部不适。这项研究的广泛目标是：1）确定胃运动异常的患病率和可遗传的组成部分（例如GP，胃异常缺乏症）和与T2DM的同胞配对中的类似衰弱的症状； 2）研究急性挑衅性测试期间的消化不良症状和胃运动功能障碍的机制； 3）确定高血糖治疗对消化不良症状和胃运动障碍的影响。具体目的是：1）确定在一个大型，特征良好的社区兄弟姐妹对T2DM的大型，特征良好的基于​​社区的兄弟姐妹中，目前正在参加NIH赞助的研究中的大型，良好，社区的兄弟姐妹对人群中的患病率； 2）将有或不带有GP的T2DM与兄弟姐妹对中的人口统计学，症状，实验室结果，胃运动测试数据以及可遗传的组件相关联； 3）通过测量胃肌电活性和选定的激素（例如，生长素蛋白，胆囊化蛋白和加压素）来研究GP和消化不良症状的机制； 4）确定侵袭性葡萄糖控制对消化不良症状和胃运动功能的影响。研究设计结合了1200名特征良好的T2DM患者的数据库的200个同胞对。症状问卷，固相胃排空研究和挑衅性测试餐记录的录音将在5年期间完成（长期研究）。这些研究的结果将确定胃病和消化不良症状的患病率在一项针对T2DM的大量人群的全面研究中。在挑衅性的水负荷测试和热量餐测试期间，有或没有GP的T2DM患者将接受非侵入性生理测试和激素分析。这些研究的结果将为有或没有GP的T2DM患者的餐后症状提供新的见解。在短期研究中，将对患有GP和HBA1C> 8的患者进行积极治疗，以在6个月的时间段内获得正常的葡萄糖水平和HBA1C水平，并与T2DM正常胃排空和HBA1C <8的T2DM患者相比。 3个月和6个月后，将重复进行非热量和热量粉末测试的电astrongragragron测试，并在治疗6个月后进行固相胃排空测试。短期研究的结果将表明高血糖对T2DM患者的症状，胃功能不全和GP的相关性。在美国，T2DM流行，许多患者的胃运动障碍无法识别。拟议的研究将确定T2DM患者“糖尿病性胃”的患病率，研究消化不良症状的机制和胃神经肌肉功能障碍，并评估高血糖症在胃运动功能障碍中的作用