Gastroesophageal Reflux Disease is Inversely Related with Glycemic Control in Morbidly Obese Patients
| Autor: | Carlos Augusto Scussel Madalosso, Cassiano M. Forcelini, Fernando Fornari, Liana Ortiz Ruas, Adriana Lauffer |
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| Rok vydání: | 2011 |
| Předmět: |
Adult
Blood Glucose Male medicine.medical_specialty Esophageal pH Monitoring Adolescent Manometry Endocrinology Diabetes and Metabolism Gastroenterology Diabetes Complications Hiatal hernia Young Adult chemistry.chemical_compound Surveys and Questionnaires Diabetes mellitus Internal medicine medicine Humans Prospective Studies Prospective cohort study Glycemic Glycated Hemoglobin Nutrition and Dietetics medicine.diagnostic_test business.industry Heartburn Middle Aged medicine.disease digestive system diseases Obesity Morbid Cross-Sectional Studies Endocrinology chemistry Barium Gastroesophageal Reflux GERD Female Surgery Esophagoscopy Glycated hemoglobin medicine.symptom Esophageal pH monitoring business |
| Zdroj: | Obesity Surgery. 21:864-870 |
| ISSN: | 1708-0428 0960-8923 |
| DOI: | 10.1007/s11695-011-0372-7 |
| Popis: | The link between diabetes mellitus and gastroesophageal reflux disease (GERD) is controversial. We assessed the relationship between glycemic control (GC) and GERD in morbidly obese patients.Consecutive patients with morbid obesity (n = 86) underwent manometry, pH-metry, endoscopy, and contrasted X-ray after responding to a GERD questionnaire and dosing fasting plasma glucose (FPG) and glycated hemoglobin (HbA1c). Patients with poor GC (HbA1c, 6.1-10% and FPG140 mg/dl) and those with very poor GC (HbA1c10% or FPG140 mg/dl) were compared.There were 63 patients with poor GC and 17 with very poor GC. Compared to patients with very poor GC, patients with poor GC showed higher heartburn scores [8 (0-12) vs. 0 (0-4); P = 0.003]; higher total esophageal acid exposure [5.2% (2.5-10.5%) vs. 2.3% (0.8-7.5%); P = 0.041]; lower distal esophageal amplitude (105 ± 38 vs. 134 ± 63 mmHg; P = 0.019); higher expiratory gastroesophageal pressure gradient (GEPG, 7 ± 3.4 vs. 5.2 ± 3 mmHg; P = 0.050); lower ventilatory gradient (inspiratory-expiratory GEPG, 10.9 ± 3.8 vs. 13.6 ± 4.1 mmHg; P = 0.012); lower waist-to-hip ratio (0.95 vs. 1; P = 0.040); and more hiatal hernia (38% vs. 6%; P = 0.016).This study suggests an inverse relation between glycemic control and GERD in morbidly obese patients. This can be partially explained by a lower frequency of hiatal hernia in patients with very poor glycemic control. |
| Databáze: | OpenAIRE |
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