Predictors of gastric myoelectrical activity in type 2 diabetes mellitus.
BACKGROUND
Previous studies have clearly demonstrated the delayed gastric emptying of solid meals in diabetics, whereas their gastric myoelectrical activity, which primarily determines gastric motility, has not yet been fully confirmed.


OBJECTIVE
This study aimed to clarify the characteristics and potential predictors of gastric myoelectrical activity in type 2 diabetics.


METHODS
Twenty-eight diabetics and 18 healthy controls participated. Duodenal biopsy sample was used for reverse transcription-polymerase chain reaction to evaluate cholecystokinin and motilin mRNA contents. Electrogastrography was performed before and after the test meal, and was assessed in terms of dominant frequency; dominant frequency instability coefficient; and the percentage of bradygastria, normogastria, and tachygastria.


RESULTS
Over the entire recording period, dominant frequency was significantly lower, and dominant frequency instability coefficient and the percentage of bradygastria were significantly higher in diabetics than in controls. In diabetics, the multiple regression analysis demonstrated that dominant frequency instability coefficient and the percentage of tachygastria in the fasting period were dependent on fasting plasma glucose level and HbA1c, respectively. Moreover, dominant frequency over the entire period and the postprandial percentage of bradygastria were significantly associated with body mass index; the fasting percentage of bradygastria and postprandial dominant frequency instability coefficient were associated with fasting serum leptin level; the postprandial percentage of bradygastria was also associated with cholecystokinin mRNA content.


CONCLUSIONS
Gastric myoelectrical activity in type 2 diabetics is impaired on dominant frequency, dominant frequency instability coefficient, and the percentage of bradygastria and predicted by body mass index, fasting serum leptin level, and cholecystokinin mRNA content besides the glycemic status.
Hata
Noriyuki
N
Department of Internal and Geriatric Medicine, Kobe University Graduate School of Medicine, Kobe, Japan.
Murata
Shigemasa
S
Maeda
Jun
J
Yatani
Hirofumi
H
Kohno
Yasuhiro
Y
Yokono
Koichi
K
Okano
Hiroyuki
H
D000368:Aged; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000378:metabolism; D015992:Body Mass Index; D016022:Case-Control Studies; D002766:Cholecystokinin / Q000235:genetics; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications* / Q000503:physiopathology; D004576:Electromyography; D005215:Fasting / Q000097:blood; D005260:Female; D005746:Gastric Emptying; D018589:Gastroparesis / Q000097:blood / Q000209:etiology* / Q000503:physiopathology; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D020738:Leptin / Q000097:blood; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D009037:Motilin / Q000235:genetics; D016065:Myoelectric Complex, Migrating; D019518:Postprandial Period; D012333:RNA, Messenger / Q000032:analysis; D018570:Risk Assessment; D012307:Risk Factors; D013270:Stomach / Q000503:physiopathology*
D015415:Biomarkers; D001786:Blood Glucose; D002766:Cholecystokinin; D006442:Glycated Hemoglobin; D020738:Leptin; D009037:Motilin; D012333:RNA, Messenger; C517652:hemoglobin A1c protein, human