Relationship between esophageal dysfunction and neuropathy in diabetic patients.
OBJECTIVE
Few studies have compared esophageal dysfunction with diabetic neuropathy, and their relationship is not yet clear. The aim of this study was to investigate the relationship between esophageal function and diabetic neuropathy.


METHODS
A total of 59 patients with type 2 diabetes were studied. Long-term ambulatory esophageal pH and motility monitoring were performed. The motor nerve conduction velocity (MCV) and coefficient of variation of R-R intervals (CVRR) were also examined.


RESULTS
The 59 patients were classified into four groups: group 1 consisted of patients with both diabetic autonomic neuropathy (DAN) and diabetic motor neuropathy (DMN), group 2 had DMN alone, group 3 had DAN alone, and group 4 had neither DAN nor DMN. In pH monitoring, differences were observed among the four groups in DeMeester score, total number of acid reflux episodes, and % time pH < 4 (p < 0.05). A correlation was observed between % time pH < 4 and MCV; however, no correlation with CVRR was observed. In motility monitoring, differences were observed among the four groups in amplitude of peristaltic waves (p < 0.001), rising velocity of peristaltic waves (p < 0.01), and percentage of effective peristalsis (p < 0.01). A correlation was observed between esophageal motility and MCV; however, no correlation with CVRR was observed.


CONCLUSIONS
Esophageal motility disorder and abnormal acid reflux were related to DMN in diabetic patients. A significant correlation was found between esophageal dysfunction and MCV. However, no significant correlation was found between esophageal dysfunction and CVRR.
Kinekawa
F
F
Department of Internal Medicine, Uchinomi Hospital, Kagawa, Japan.
Kubo
F
F
Matsuda
K
K
Fujita
Y
Y
Tomita
T
T
Uchida
Y
Y
Nishioka
M
M
D000368:Aged; D001342:Autonomic Nervous System Diseases / Q000150:complications / Q000503:physiopathology; D003929:Diabetic Neuropathies / Q000150:complications* / Q000503:physiopathology; D004553:Electric Conductivity; D015154:Esophageal Motility Disorders / Q000150:complications* / Q000503:physiopathology; D004947:Esophagus / Q000737:chemistry / Q000503:physiopathology; D005260:Female; D006339:Heart Rate; D006801:Humans; D006863:Hydrogen-Ion Concentration; D008297:Male; D008875:Middle Aged; D016472:Motor Neuron Disease / Q000150:complications / Q000503:physiopathology; D009046:Motor Neurons / Q000502:physiology; D010528:Peristalsis