title: Measures of Autonomic Dysfunction in Diabetic and Idiopathic Gastroparesis.
abstract: BACKGROUND
  Gastroparesis is a condition classically characterized by delayed gastric emptying and is associated with considerable morbidity. While the etiology of gastroparesis remains elusive, autonomic dysfunction may play an important role, especially as many patients with gastroparesis also have diabetes. The aim of this study was to determine whether measures of autonomic function differ between adults with diabetic gastroparesis (DG) and adults with idiopathic gastroparesis (IG).
  
  
  METHODS
  Tests of systemic autonomic function were performed among 20 adults with GD (six men and 14 women, mean age: 42 years) and 21 adults with IG (seven men and 14 women, mean age: 37 years). Measures included vagal cholinergics by R-R interval percentage variation (RRI-PV) and sympathetic adrenergics by vasoconstriction to cold (VC) and postural adjustment ratio (PAR). The two groups were compared using Wilcoxon rank sum tests and linear regression analysis (STATA 10.0).
  
  
  RESULTS
  In univariate analysis, the following autonomic measures differed significantly between DG and IG: VC (P = 0.004), PAR (P = 0.045), VC + PAR (P = 0.002) and RRI-PV (P < 0.001). In multivariate analysis (P = 0.002, R2= 0.55), only RRI-PV (adjusted odds ratio (aOR): 1.02, 95% confidence interval (CI): 1.01 - 1.03) differed significantly between DG and IG patients.
  
  
  CONCLUSIONS
  Vagal cholinergics are affected to a greater degree in DG compared to IG, suggesting that impaired vagal tone is not a universal mechanism for gastroparesis.
authors: Division of Gastroenterology, Hepatology & Nutrition, Department of Medicine, University of Louisville, Louisville, KY, USA.
authors: Mohammad Khalid
authors: MK
authors: Mohammad
authors: Department of Medicine, University of Mississippi Medical Center, Jackson, MS; Critical Care Medicine Department, National Institutes of Health, Bethesda, MD, USA.
authors: Dominique J
authors: DJ
authors: Pepper
authors: Division of Gastroenterology, Hepatology & Nutrition, Department of Medicine, University of Louisville, Louisville, KY, USA.
authors: Archana
authors: A
authors: Kedar
authors: AmeriPath Indiana, Indianapolis, IN, USA.
authors: Feriyl
authors: F
authors: Bhaijee
authors: US Army Research, Development and Engineering Command, NVESD, Ft. Belvoir, VA, USA.
authors: Babajide
authors: B
authors: Familoni
authors: Neuroscience Institute and Cancer Center, Methodist University Hospital, Memphis, TN, USA.
authors: Hani
authors: H
authors: Rashed
authors: Division of Public Health, Wake Forest School of Medicine, Winston Salem, NC, USA.
authors: Teresa
authors: T
authors: Cutts
authors: Division of Gastroenterology, Hepatology & Nutrition, Department of Medicine, University of Louisville, Louisville, KY, USA.
authors: Thomas L
authors: TL
authors: Abell
keywords: Autonomic nervous system; Diabetes; Gastroparesis; Sympathetic function; Vagal dysfunction