PECULIARITIES OF STATE OF PROTECTION AND AGGRESSION FACTORS IN PATIENTS WITH DIABETES MELLITUS TYPE II AND GASTROESOPHAGEAL REFLUX DISEASE
Diabetes mellitus is one of the most serious problems of the clinical medicine. This is determined by the fact that it is followed by multisystemic affects, as well as complications on the side of other organs and systems, among which a special place is occupied by gastroesophageal reflux disease. As for the combination and mutual influence of diabetes mellitus and gastroesophageal reflux disease, this issue has not been studied yet, the data of modern literature are not complete and quite contradictory.
The aim of the study: to investigate the state of the factors of aggression and protection of the oesophageal mucosa in patients with diabetes mellitus type II with concomitant gastroesophageal reflux disease without associated pathology.
Method. There were two groups of patients under observation. The first group included 45 patients with diabetes mellitus type II with concomitant gastroesophageal reflux disease (26 men and 19 women). The second group included 38 patients with gastroesophageal reflux disease without associated pathology – 20 men and 18 women. By sex, age, body weight, Helicobacter pylori infection, smoking and alcohol consumption, both groups were comparable. The surveillance program included determining the compensation ratio of carbohydrate metabolism and the state of the factor. The antioxidant protection factor was assessed by the level of catalase activity in the blood serum, as well as by the diameter of the celiac trunk and the blood flow velocity in it. Statistical processing of the obtained data was carried out with the aid of the program WINDOWS STATISTIKA 6.0. For all types of analysis, differences were considered statistically significant with p<0.05.
Results. During the study, we found that in patients with diabetes mellitus type II with concomitant gastroesophageal reflux disease, as well as in patients with gastroesophageal reflux disease without associated pathology, the level of pH-metry was reduced, but with varying measures of confidence. At the same time, we found that patients with GERD without associated pathology had a decrease in the blood flow velocity in the celiac trunk. Concurrently, we ascertained that the decrease in the blood flow velocity in patients of both groups reduced the diameter of the celiac trunk.
Conclusions. In patients with diabetes mellitus type II, concomitant gastroesophageal reflux disease has a subtle clinical presentation that is affected by a significant decline in mucosal sealing protection factors. In patients with GERD without associated pathology, typical clinical manifestations, accompanied by inflammation, acid regurgitation and dyspepsia, are more vivid.
Becker, C., Meier, C. R., Jick, S. S., Bodmer, M. (2013). Case–control analysis on metformin and cancer of the esophagus. Cancer Causes & Control, 24 (10), 1763–1770. doi: http://doi.org/10.1007/s10552-013-0253-6
Kahrilas, P. J., Howden, C. W., Wernersson, B., Denison, H., Nuevo, J., Gisbert, J. P. (2013). Impact of persistent, frequent regurgitation on quality of life in heartburn responders treated with acid suppression: a multinational primary care study. Alimentary Pharmacology & Therapeutics, 37 (10), 1005–1010. doi: http://doi.org/10.1111/apt.12298
Promberger, R., Lenglinger, J., Riedl, O., Seebacher, G., Eilenberg, W. H., Ott, J. et. al. (2013). Gastro-oesophageal reflux disease in type 2 diabetics: symptom load and pathophysiologic aspects – a retro-pro study. BMC Gastroenterology, 13 (1). doi: http://doi.org/10.1186/1471-230x-13-132
Rubenstein, J. H., Chen, J. W. (2014). Epidemiology of Gastroesophageal Reflux Disease. Gastroenterology Clinics of North America, 43 (1), 1–14. doi: http://doi.org/10.1016/j.gtc.2013.11.006
Association between tea consumption and gastroesophageal reflux disease. (2019). Medicine, 98 (10), e14915. doi: http://doi.org/10.1097/md.0000000000014915
Walker, M. M., Powell, N., Talley, N. J. (2014). Atopy and the gastrointestinal tract – a review of a common association in unexplained gastrointestinal disease. Expert Review of Gastroenterology & Hepatology, 8 (3), 289–299. doi: http://doi.org/10.1586/17474124.2014.881716
Boeckxstaens, G., El-Serag, H. B., Smout, A. J. P. M., Kahrilas, P. J. (2014). Symptomatic reflux disease: the present, the past and the future. Gut, 63 (7), 1185–1193. doi: http://doi.org/10.1136/gutjnl-2013-306393
Hirata, A., Kishida, K., Nakatsuji, H., Inoue, K., Hiuge-Shimizu, A., Funahashi, T., Shimomura, I. (2012). High prevalence of gastroesophageal reflux symptoms in type 2 diabetics with hypoadiponectinemia and metabolic syndrome. Nutrition & Metabolism, 9 (1), 4. doi: http://doi.org/10.1186/1743-7075-9-4
Agrawal, S., Patel, P., Agrawal, A., Makhijani, N., Markert, R., Deidrich, W. (2014). Metformin Use and the Risk of Esophageal Cancer in Barrett Esophagus. Southern Medical Journal, 107 (12), 774–779. doi: http://doi.org/10.14423/smj.0000000000000212
Kahrilas, P. J., McColl, K., Fox, M., OʼRourke, L., Sifrim, D., Smout, A. J. P. M., Boeckxstaens, G. (2013). The Acid Pocket: A Target for Treatment in Reflux Disease? American Journal of Gastroenterology, 108 (7), 1058–1064. doi: http://doi.org/10.1038/ajg.2013.132
Katz, P. O., Gerson, L. B., Vela, M. F. (2013). Guidelines for the Diagnosis and Management of Gastroesophageal Reflux Disease. American Journal of Gastroenterology, 108 (3), 308–328. doi: http://doi.org/10.1038/ajg.2012.444
Krishnan, B. (2013). Gastrointestinal complications of diabetes mellitus. World Journal of Diabetes, 4 (3), 51. doi: http://doi.org/10.4239/wjd.v4.i3.51
Lee, D., Lee, K. J., Kim, K. M., Lim, S. K. (2013). Prevalence of asymptomatic erosive esophagitis and factors associated with symptom presentation of erosive esophagitis. Scandinavian Journal of Gastroenterology, 48 (8), 906–912. doi: http://doi.org/10.3109/00365521.2013.812236
Lim, C.-H., Choi, M.-G., Baeg, M. K., Moon, S. J., Kim, J. S., Cho, Y. K. et. al. (2014). Symptom Characteristics and Psychosomatic Profiles in Different Spectrum of Gastroesophageal Reflux Disease. Gut and Liver, 8 (2), 165–169. doi: http://doi.org/10.5009/gnl.2014.8.2.165
Lundell, L. (2014). Borderline Indications and Selection of Gastroesophageal Reflux Disease Patients: ‘Is Surgery Better than Medical Therapy? Digestive Diseases, 32 (1-2), 152–155. doi: http://doi.org/10.1159/000357182
Natalini, J., Palit, A., Sankineni, A., Friedenberg, F. K. (2014). Diabetes mellitus is an independent risk for gastroesophageal reflux disease among urban African Americans. Diseases of the Esophagus, 28 (5), 405–411. doi: http://doi.org/10.1111/dote.12213
Oparin, A. A., Beziazychna, N. V. (2016). Implementation mechanisms of psychosomatic disorders in gastroesophageal reflux disease with concomitant chronic obstructive pulmonary disease. Med Jad, 46 (1-2), 125–132.
Oparin, A., Kornienko, D. (2017). Formation process of motor-evacuatory disorders in patients with gastroesophageal reflux disease and concomitant obesity. Gastroenterologie a Hepatologie, 71 (2), 145–149. doi: http://doi.org/10.14735/amgh2017csgh.info01
Shekhovtsova, Y., Zhuravlyova, L. (2015). Exocrine pancreatic function in patients with type 2 diabetes mellitus with different phenotype. Pancreatology, 15 (3), S72–S73. doi: http://doi.org/10.1016/j.pan.2015.05.273
Stevens, J. E., Jones, K. L., Rayner, C. K., Horowitz, M. (2013). Pathophysiology and pharmacotherapy of gastroparesis: current and future perspectives. Expert Opinion on Pharmacotherapy, 14 (9), 1171–1186. doi: http://doi.org/10.1517/14656566.2013.795948
Sun, X.-M. (2015). Association between diabetes mellitus and gastroesophageal reflux disease: A meta-analysis. World Journal of Gastroenterology, 21 (10), 3085. doi: http://doi.org/10.3748/wjg.v21.i10.3085
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