老年2型糖尿病患者胃排空功能影响因素分析

An Analysis of Factors Influencing Gastric Emptying Function in Elderly Patients with Type 2 Diabetes

目的探讨糖尿病病程、血糖控制情况、身体质量指数(body mass index,BMI)等对老年2型糖尿病(type 2 diabetes,T2DM)患者胃排空功能的影响。方法回顾性分析2021年11月至2022年12月在我院住院60岁以上T2DM患者100例,收集性别、年龄、DM病程、空腹葡萄糖(fasting plasma glucose,FPG)、餐后2h葡萄糖(2-hour postprandial blood glucose,2h PG)、糖化白蛋白(glycated albumin,GA)、糖化血红蛋白(glycosylated hemoglobin,HbAlc)、BMI以及胃排空显像半排时间(GET 1/2)、2h胃排空率(2-hour gastric emptying rates,2h GERS)。依据本单位标准将GET 1/2≥90min设定为胃排空延迟组,GET 1/2<90min为胃排空正常组,比较两组间各项检测结果的水平,分析各因素与胃排空延迟的相关性。结果胃排空延迟组与正常组比较,性别、年龄、FPG、2h PG差异无统计学意义,GA、HbA 1 c、BMI胃排空延迟组低于正常组,DM病程胃排空延迟组高于正常组,差异有统计学意义(P<0.05)。Spearman相关分析显示,GET 1/2与DM病程呈正相关(P<0.05),2h GERS与DM病程呈负相关(P<0.05)。受试者工作特征曲线(ROC)分析显示,DM病程单独预测老年T2DM患者胃排空延迟有应用价值,AUC为0.724,灵敏度为0.846、特异性为0.542,并测得cut-off值为7.5年。结论对于老年T2DM胃排空延迟发生,性别、年龄、合并的基础疾病、常见并发症等不能起到预测的作用;GET 1/2、2h GERS与2h PG、GA、HbAlc、BMI并无明确的相关性,GET 1/2与DM病程呈正相关,随着DM病程的增加胃排空延迟的发生概率增加,DM病程可以作为老年T2DM胃排空延迟发生的预测指标,其cut-off值为7.5年。

Objective To investigate the effects of Diabetes course,blood glucose control and body mass index(BMI)on gastric emptying function in elderly patients with Type 2 Diabetes(T2DM).Methods A retrospective analysis was performed on 100 patients with T2DM over 60 years old who were hospitalized in our hospital from November,2021 to December,2022.Gender,age,duration of DM,Fasting Plasma Glucose(FPG),2-hour Postprandial Blood Glucose(2hPG),Glycated albumin(GA),Glycosylated Hemoglobin,BMI,and Gastric emptying imaging half-time(GET 1/2)and 2-hour Gastric emptying rates(2hGERS)were collected from all patients.According to the unit standard,GET 1/2≥90min was set as the delayed gastric emptying group,and GET 1/2<90min was the standard for the normal gastric emptying group.The levels of various detection results between the two groups were compared,and the correlation between various factors and the delayed gastric emptying was analyzed.Results Compared with normal group,there were no significant differences in gender,age,FPG,2hPG.GA,HbA1c,BMI in the gastric emptying delay group was lower than those of the normal group,DM course in the gastric emptying delay group was higher than that of the normal group(P<0.05).Spearman correlation analysis showed that GET 1/2 was positively correlated with DM course(P<0.05),while 2hGERS was negatively correlated with DM course(P<0.05).Receiver operating characteristic curve(ROC)analysis showed that the disease course of DM alone was useful in predicting delayed gastric emptying in elderly patients with T2DM.The AUC was 0.724,with the sensitivity 0.846,the specificity 0.542,and the cut-off value 7.5 years.Conclusion Gender,age,underlying diseases and common complications cannot predict the occurrence of delayed gastric emptying in elderly patients with T2DM.There is no clear correlation between GET 1/2 and 2hGERS and 2hPG,GA,HbA1c and BMI,while GET 1/2 is positively correlated with the course of DM.With the increase of the course of DM,the incidence of delayed gastric emptying increases.The course of DM could be used as a predictor of delayed gastric emptying in elderly T2DM,with a cut-off value of 7.5 years.