AIM To determine the sensitivity and specificity of the ^(13)C-urea breath test(UBT) in patients taking proton pump inhibitors(PPIs), using a new test meal Refex. METHODS One hundred and fourteen consecutive patients ...AIM To determine the sensitivity and specificity of the ^(13)C-urea breath test(UBT) in patients taking proton pump inhibitors(PPIs), using a new test meal Refex. METHODS One hundred and fourteen consecutive patients with dyspepsia, 53 Helicobacter pylori(H. pylori) positive, 49 H. pylori negative, were included in the study. The patients were then given esomeprazole 40 mg for 29 consecutive days, and the ^(13)C-UBT with the new test meal was performed the next morning. RESULTS The sensitivity of the ^(13)C-UBT with a cut off 2.5‰ was92.45%(95%CI: 81.79%-97.91%) by per-protocol(PP) analysis and 78.13 %(95%CI: 66.03%-87.49%) by intention-to-treat(ITT) analysis. The specificity of the ^(13)C-UBT test was 96.00 % in the ITT population(95%CI: 86.29%-99.51%) and 97.96% in the PP population(95%CI: 89.15%-99.95%).CONCLUSION The new test meal based ^(13)C-UBT is highly accurate in patients on PPIs and can be used in those unable to stop their PPI treatment.展开更多
Background: A secretion of plasma active GLP-1 (p-active GLP-1) after ingestion of breakfast test meal (TM) is decreased in obese European patients with type 2 diabetes mellitus (T2DM). However, there was no significa...Background: A secretion of plasma active GLP-1 (p-active GLP-1) after ingestion of breakfast test meal (TM) is decreased in obese European patients with type 2 diabetes mellitus (T2DM). However, there was no significant difference in pactive GLP-1 secretion following TM between obese Japanese patients with T2DM and controls. The findings indicate the difference may be due to different races or dietary’s customs of subjects. Aims: We examined whether pactive GLP-1 is truly affected by TM in obese Japanese patients (n = 24, group 1) and obese controls (n = 12, group 2). Methods: Glucose (PG), insulin (s-IRI), C-peptide (s-CPR) and active GLP-1 like substances (p-active GLP-1-S) levels in blood were measured 0, 30 and 60 min after TM. Obese Japanese patients with mean 9 years of diabetes had micro- and macro-vascular disturbances and were treated with diet, exercise and/or oral drugs for hyperglycemia. Results: There was no significant difference in sex, age or BMI between groups. Means HbA1c and PG were significantly higher in group 1 than in group 2. There were no significant differences in means of basal s-IRI, HOMA-R and s-CPR between groups. However, means of HOMA-β, insulinogenic index, postprandial s-IRI, s-CPR and p-active GLP-1-S or p-active GLP-1-S/PG values after TM were significantly lower in group 1 than in group 2. Conclusions: These results indicate that a response of p-active GLP-1-S after TM in obese Japanese patients with T2DM was decreased and secretion of GLP-1 relative to PG was impaired. The method of enhancing function of active GLP-1 may be useful for treatment in some of patients with diabetes mellitus.展开更多
文摘AIM To determine the sensitivity and specificity of the ^(13)C-urea breath test(UBT) in patients taking proton pump inhibitors(PPIs), using a new test meal Refex. METHODS One hundred and fourteen consecutive patients with dyspepsia, 53 Helicobacter pylori(H. pylori) positive, 49 H. pylori negative, were included in the study. The patients were then given esomeprazole 40 mg for 29 consecutive days, and the ^(13)C-UBT with the new test meal was performed the next morning. RESULTS The sensitivity of the ^(13)C-UBT with a cut off 2.5‰ was92.45%(95%CI: 81.79%-97.91%) by per-protocol(PP) analysis and 78.13 %(95%CI: 66.03%-87.49%) by intention-to-treat(ITT) analysis. The specificity of the ^(13)C-UBT test was 96.00 % in the ITT population(95%CI: 86.29%-99.51%) and 97.96% in the PP population(95%CI: 89.15%-99.95%).CONCLUSION The new test meal based ^(13)C-UBT is highly accurate in patients on PPIs and can be used in those unable to stop their PPI treatment.
文摘Background: A secretion of plasma active GLP-1 (p-active GLP-1) after ingestion of breakfast test meal (TM) is decreased in obese European patients with type 2 diabetes mellitus (T2DM). However, there was no significant difference in pactive GLP-1 secretion following TM between obese Japanese patients with T2DM and controls. The findings indicate the difference may be due to different races or dietary’s customs of subjects. Aims: We examined whether pactive GLP-1 is truly affected by TM in obese Japanese patients (n = 24, group 1) and obese controls (n = 12, group 2). Methods: Glucose (PG), insulin (s-IRI), C-peptide (s-CPR) and active GLP-1 like substances (p-active GLP-1-S) levels in blood were measured 0, 30 and 60 min after TM. Obese Japanese patients with mean 9 years of diabetes had micro- and macro-vascular disturbances and were treated with diet, exercise and/or oral drugs for hyperglycemia. Results: There was no significant difference in sex, age or BMI between groups. Means HbA1c and PG were significantly higher in group 1 than in group 2. There were no significant differences in means of basal s-IRI, HOMA-R and s-CPR between groups. However, means of HOMA-β, insulinogenic index, postprandial s-IRI, s-CPR and p-active GLP-1-S or p-active GLP-1-S/PG values after TM were significantly lower in group 1 than in group 2. Conclusions: These results indicate that a response of p-active GLP-1-S after TM in obese Japanese patients with T2DM was decreased and secretion of GLP-1 relative to PG was impaired. The method of enhancing function of active GLP-1 may be useful for treatment in some of patients with diabetes mellitus.
