title: Clinical assessment of delayed gastric emptying and diabetic complications using gastric emptying scintigraphy: involvement of vascular disorder.
abstract: OBJECTIVE
  Delayed gastric emptying, including gastroparesis, is a common complication in diabetes mellitus. The association between delayed gastric emptying and overall diabetic complications remains to be studied in detail. We analysed this association.
  
  
  METHODS
  We performed gastric emptying scintigraphy of (99m) Tc-diethylenetriaminepentaacetic acid in 34 patients with diabetes to measure the gastric emptying half-times (T1/2) of the whole stomach (WS), proximal stomach (PS) and distal stomach (DS). We assessed T1/2, diabetic-related factors and complications.
  
  
  RESULTS
  The prevalence of autonomic neuropathy was higher in the group with delayed T1/2 of the WS than in the normal group. Analysis of intima-media thickness (IMT) and ankle brachial pressure index (ABI), which are risk indicators for vascular disorder, showed that IMT of the carotid bulb was greater in the group with delayed T1/2 of the WS than in the normal group (2·41 mm [1·50-2·81] versus 1·40 mm [0·81-2·08], P = 0·015). T1/2 of the WS correlated positively with IMT of the carotid bulb (r = 0·391, P = 0·027) and negatively with ABI (r = -0·389, P = 0·028). These correlations were mainly attributed to PS and were the same in patients without autonomic neuropathy. In seven of nine patients who received scintigraphy again after diabetic treatment, glycosylated haemoglobin (HbA1c) levels decreased and T1/2 of the WS shortened compared with before treatment.
  
  
  CONCLUSIONS
  Vascular disorder, among other cofactors such as autonomic neuropathy, could be involved in the pathophysiology of delayed gastric emptying. Medium- to long-term glycaemic control was associated with gastric emptying.
authors: Department of Nuclear Medicine, Graduate School of Medicine, Osaka City University, Osaka, Japan.
authors: Kohei
authors: K
authors: Kotani
authors: Joji
authors: J
authors: Kawabe
authors: Etsushi
authors: E
authors: Kawamura
authors: Naoya
authors: N
authors: Kawano
authors: Masanori
authors: M
authors: Emoto
authors: Atsushi
authors: A
authors: Yoshida
authors: Shigeaki
authors: S
authors: Higashiyama
authors: Tomoaki
authors: T
authors: Morioka
authors: Masaaki
authors: M
authors: Inaba
authors: Susumu
authors: S
authors: Shiomi
mesh_terms: D000368:Aged; D055109:Ankle Brachial Index; D059168:Carotid Intima-Media Thickness; D003925:Diabetic Angiopathies / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000503:physiopathology; D003929:Diabetic Neuropathies / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000503:physiopathology; D005260:Female; D005746:Gastric Emptying / Q000187:drug effects; D018589:Gastroparesis / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000503:physiopathology; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D013270:Stomach / Q000000981:diagnostic imaging* / Q000503:physiopathology; D016284:Technetium Tc 99m Pentetate; D013997:Time Factors
chemical_list: D007004:Hypoglycemic Agents; D019275:Radiopharmaceuticals; D016284:Technetium Tc 99m Pentetate
keywords: diabetes mellitus; diabetic complications; gastric emptying; scintigraphy; vascular disorder