Clinical characteristics of gastroesophageal reflux disease in adolescents with diabetic cardiac autonomic neuropathy
https://doi.org/10.14341/DM2014493-98
Abstract
Aim.
We evaluated the clinical and functional characteristics of gastroesophageal reflux disease (GERD) in adolescents with a cardiac form of diabetic autonomic neuropathy.
Patients and methods.
Fifty-two adolescents, aged 12?17 years, with type 1 diabetes were studied. Patients were divided into two groups according to the results of two autonomic tests (cardiointervalography and Valsalva test). Group 1 included 14 adolescents with a cardiac form of diabetic autonomic neuropathy. Group 2 included 38 controls. Oesophageal pH parameters were monitored over 24 h using a Gastroscan-24. The 24-h period was divided into day-time (08:00?22:00) and night-time (22:00?08:00) periods to eliminate the influence of exogenous factors (such as eating, physical activity and change of body position) on the oesophageal kinetic function.
Results.
Pathological gastroesophageal reflux occurred more frequently in Group 1 (78.5%) than in Group 2 (36.8%; p=0.018). Heartburn was experienced by 14.3% of the patients in Group 1 and generally occurred with similar frequency in the two groups (p=0.91). The daily amount of pathological acid reflux in Group 1 (86 [62?141]) was higher versus Group 2 (52.5 [24?108]; p=0.047) that was associated with night-time reflux in Group 1. A correlation analysis demonstrated the increase of frequency and intensity of the acid reflux due to development of parasympathetic insufficiency.
Conclusion.
Diabetic autonomic neuropathy in adolescents with type 1 diabetes appears to be a significant risk factor for the development of pathological subclinical GERD with altered daily pattern.
We evaluated the clinical and functional characteristics of gastroesophageal reflux disease (GERD) in adolescents with a cardiac form of diabetic autonomic neuropathy.
Patients and methods.
Fifty-two adolescents, aged 12?17 years, with type 1 diabetes were studied. Patients were divided into two groups according to the results of two autonomic tests (cardiointervalography and Valsalva test). Group 1 included 14 adolescents with a cardiac form of diabetic autonomic neuropathy. Group 2 included 38 controls. Oesophageal pH parameters were monitored over 24 h using a Gastroscan-24. The 24-h period was divided into day-time (08:00?22:00) and night-time (22:00?08:00) periods to eliminate the influence of exogenous factors (such as eating, physical activity and change of body position) on the oesophageal kinetic function.
Results.
Pathological gastroesophageal reflux occurred more frequently in Group 1 (78.5%) than in Group 2 (36.8%; p=0.018). Heartburn was experienced by 14.3% of the patients in Group 1 and generally occurred with similar frequency in the two groups (p=0.91). The daily amount of pathological acid reflux in Group 1 (86 [62?141]) was higher versus Group 2 (52.5 [24?108]; p=0.047) that was associated with night-time reflux in Group 1. A correlation analysis demonstrated the increase of frequency and intensity of the acid reflux due to development of parasympathetic insufficiency.
Conclusion.
Diabetic autonomic neuropathy in adolescents with type 1 diabetes appears to be a significant risk factor for the development of pathological subclinical GERD with altered daily pattern.
About the Authors
Sergey Evgen'evich Kostyakov
Smolensk State Medical Academy, Smolensk
Russian Federation
MD, endocrinologist, PhD-student at the Pediatrics and Neonatology Chair of the Continuous Medical Education and Professional Training Faculty
Russian Federation
MD, endocrinologist, PhD-student at the Pediatrics and Neonatology Chair of the Continuous Medical Education and Professional Training Faculty
Irina Leonidovna Alimova
Smolensk State Medical Academy, Smolensk
Russian Federation
Competing Interests: отсутствует конфликт интересов
Russian Federation
MD, PhD, Professor, Head of the Pediatrics and Neonatology Chair of the Continuous Medical Education and Professional Training Faculty, leading specialist in endocrinology of Smolensk Regional Health Department
Competing Interests: отсутствует конфликт интересов
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For citations:
Kostyakov S.E., Alimova I.L. Clinical characteristics of gastroesophageal reflux disease in adolescents with diabetic cardiac autonomic neuropathy. Diabetes mellitus. 2014;17(4):93-98. (In Russ.) https://doi.org/10.14341/DM2014493-98
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