Araştırma Makalesi
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Erken doyma ve bulantı diyabetik gastroparezisi olan ve olmayan tip 2 Diabetes Mellituslu hastalarda kötü hayat kalitesinin bağımsız belirleyicileridir

Yıl 2017, Cilt: 1 Sayı: 3, 110 - 115, 15.12.2017
https://doi.org/10.30565/medalanya.337300

Öz

Amaç: Biz diyabetik gastroparezi varlığı
ile demografik özellikler, semptom ciddiyeti ve hayat kalitesi arasındaki
ilişkiyi göstermeyi amaçladık.

Hastalar ve Yöntem: Bu çalışmaya Tip 2 Diyabetes
Mellituslu (DM) hastalar alındı. Hastalara yüz yüze demografik profili, üst
gastrointestinal sistem bozukları semptom ciddiyeti (PAGI-SYM) ve hayat
kalitesi (PAGI-QOL) hasta değerlendirilmesi ile ilgili sorular soruldu.

Bulgular: Bu çalışmaya Tip 2 DM’li toplam 51
hasta alındı. Diyabetik gastroparezisi olmayan ve olan Tip 2 DM’li hastaların
ortalama yaşları sırasıyla 53.35±6.98 ve 57.04±9.41 (p=0.192) di. Diyabetik
gastroparezisi olan ve olmayan hastaların her ikisinde de PAGI-SYM skoruna göre
en ciddi semptomu şişkinlikti (2.69±2.21 ve 2.57±2.22). Çalışmamızda bulantı PAGI-QOL
temel alınarak kötü hayat kalitesi ile koreleydi, fakat bulantı uzamış mide
boşalma zamanı ile korele değildi (coef: 0.351, 95% CI: 0.035-0.667, p=0.030).
Bulantı skoru bozulmuş hayat kalitesi ile koreleydi (coef: 0.207, 95% CI:
0.085-0.330, p<0.001). Erken doyma ve erken doyma skorunun her ikisi de kötü
hayat kalitesi ile güçlü koreleydi (coef: 1.061, %95CI:0.699-1.424, p<0.001
ve coef:1.136, 95%CI:0.791-1.480, p<0.001).

Sonuç: Erken
doyma ve bulantı diyabetik gastroparezisi olan ve olmayan Tip 2 DM’li
hastalarda istatistiksel anlamlı olarak kötü hayat kalitesinin bağımsız
belirleyicileridir.

Ayrıca bulantı, karın ağrısı, şişkinlik ve pyroz
PAGI-SYM skorlarıyla anlamlı derecede ilişkiliydi.










Kaynakça

  • 1. Camilleri M, Brown ML, Malagelada JR. Relationship between impaired gastric emptying and abnormal gastrointestinal motility. Gastroenterology 1986;91:94-9.
  • 2. Houghton LA, Read NW, Heddle R, Horowitz M, et al. Relationship of the motor activity of the antrum, pylorus, and duodenum to gastric emptying of a solid-liquid mixed meal. Gastroenterology 1988;94:1285-91.
  • 3. Mearin F, Camilleri M, Malagelada JR. Pyloric dysfunction in diabetics with recurrent nausea and vomiting. Gastroenterology 1986; 90: 1919-25.
  • 4. Hyett B, Martinez FJ, Gill BM, Mehra S, Lembo A, Kelly CP, et al. Delayed radionucleotide gastric emptying studies predict morbidity in diabetics with symptoms of gastroparesis. Gastroenterology 2009;137:445-52.
  • 5. Maleki D, Locke GR III, Camilleri M, Zinsmeister AR, Yawn BP, Leibson C, et al. Gastrointestinal tract symptoms among persons with diabetes mellitus in the community. Arch Intern Med. 2000; 160: 2808-16.
  • 6. Bytzer P, Talley NJ, Leemon M, Young LJ, Jones MP, Horowitz M. Prevalence of gastrointestinal symptoms associated with diabetes mellitus: a population-based survey of 15,000 adults. Arch Intern Med. 2001; 161: 1989-96.
  • 7. Talley NJ, Bytzer P, Hammer J, Young L, Jones M, Horowitz M. Psychological distress is linked to gastrointestinal symptoms in diabetes mellitus. Am J Gastroenterol. 2001; 96: 1033-1038.
  • 8. Punkkinen J, Färkkilä M, Mätzke S, et al. Upper abdominal symptoms in patients with Type 1 diabetes: unrelated to impairment in gastric emptying caused by autonomic neuropathy. Diabet Med. 2008; 25: 570-7.
  • 9. Talley NJ, Young L, Bytzer P, Hammer J, Leemon M, Jones M, et al. Impact of chronic gastrointestinal symptoms in diabetes mellitus on health-related quality of life. Am J Gastroenterol. 2001; 96: 71-6.
  • 10. Rentz AM, Kahrilas P, Stanghellini V, Tack J, Talley NJ, de la Loge C, et al. Development and psychometric evaluation of the patient assessment of upper gastrointestinal symptom severity index (PAGI-SYM) in patients with upper gastrointestinal disorders. Qual Life Res. 2004; 13(10): 1737–49.
  • 11. Revicki DA, Rentz AM, Dubois D, Kahrilas P, Stanghellini V, Talley NJ, et al. Development and validation of a patient-assessed gastroparesis symptom severity measure: the Gastroparesis Cardinal Symptom Index. Aliment Pharmacol Ther. 2003; 18: 141–50.
  • 12. Revicki DA, Rentz AM, Dubois D, Kahrilas P, Stanghellini V, Talley NJ, et al. Gastroparesis Cardinal Symptom Index (GCSI): development and validation of a patient reported assessment of severity of gastroparesis symptoms. Qual Life Res. 2004; 13: 833– 44.
  • 13. de la Loge C, Trudeau E, Marquis P, Kahrilas P, Stanghellini V, Talley NJ, et al. Cross-cultural development and validation of a patient self-administered questionnaire to assess quality of life in upper gastrointestinal disorders: The PAGI-QOL. Qual Life Res. 2004; 13: 1751–62.
  • 14. Thomforde GM, Camilleri M, Phillips SF, Forstrom LA. Evaluation of an inexpensive screening scintigraphic test of gastric emptying. J Nucl Med. 1995; 36: 93–6.
  • 15. Tougas GH, Eaker EY, Abell TL, Abrahamsson H, Boivin M, Chen J, et al. Assessment of gastric emptying using a low fat meal: establishment of international control values. Am J Gastroenterol. 2000; 95: 1456 – 62.
  • 16. Jaffe JK, Paladugu S, Gaughan JP, Parkman HP. Characteristics of nausea and its effects on quality of life in diabetic and idiopathic gastroparesis. J Clin Gastroenterol. 2011; 45(4): 317-21.
  • 17. Cherian D, Parkman HP. Nausea and vomiting in diabetic and idiopathic gastroparesis. Neurogastroenterol Motil. 2012; 24(3): 217-22.
  • 18. Cherian D, Sachdeva P, Fisher RS, Parkman HP. Abdominal pain is a frequent symptom of gastroparesis. Clin Gastroenterol Hepatol. 2010; 8(8): 676-81.
  • 19. Hasler WL, Wilson LA, Parkman HP, et al. Factors related to abdominal pain in gastroparesis: contrast to patients with predominant nausea and vomiting. Neurogastroenterol Motil. 2013;25(5):427-38.

Early satiation and nausea are independent determinants of poor quality of life in patients with type 2 diabetes mellitus with and without diabetic gastroparesis

Yıl 2017, Cilt: 1 Sayı: 3, 110 - 115, 15.12.2017
https://doi.org/10.30565/medalanya.337300

Öz

Aim: We aimed to show the relationship between presence of diabetic gastroparesis and demographic features, symptom severity, quality of life. 

Patients and Method: Patients with type 2 Diabetes Mellitus (DM) were enrolled in this study. Patients were interviewed face to face in terms of demographic profile, the Patient Assessment of Upper Gastrointestinal Disorder Symptoms (PAGI-SYM), and the Patient Assessment of Upper Gastrointestinal Disorders QOL (PAGI-QOL).

Results: A total of 51 patients with type 2 DM were included in this study. The mean age of the type 2 DM patients without and with diabetic gastroparesis were respectively 53.35±6.98 and 57.04±9.41 (p=0.192). The most severe of symptoms based on PAG-SYM score was bloating in both patients with and without diabetic gastroparesis (2.69±2.21 and 2.57±2.22).  In this study, nausea was correlated with poor quality of life based on PAGI-QOL but not with delayed gastric emptying (coef: 0.351, 95% CI: 0.035-0.667, P=0.030). Also, nausea score was correlated with impaired quality of life (coef: 0.207, 95% CI: 0.085-0.330, p<0.001). Both early satiation  and early satiation  score were significantly correlated with poor quality of life (coef: 1.061, %95CI:0.699-1.424, p<0.001 and coef:1.136, 95%CI:0.791-1.480, p<0.001) in our study.

Conclusion: Early satiation and nausea are statistically significant independent predictors of poor quality of life in patients with Type 2 DM with and without diabetic gastroparesis. Also, nausea, abdominal pain, bloating and pyrosis were significantly associated with PAGI-SYM scores.

Kaynakça

  • 1. Camilleri M, Brown ML, Malagelada JR. Relationship between impaired gastric emptying and abnormal gastrointestinal motility. Gastroenterology 1986;91:94-9.
  • 2. Houghton LA, Read NW, Heddle R, Horowitz M, et al. Relationship of the motor activity of the antrum, pylorus, and duodenum to gastric emptying of a solid-liquid mixed meal. Gastroenterology 1988;94:1285-91.
  • 3. Mearin F, Camilleri M, Malagelada JR. Pyloric dysfunction in diabetics with recurrent nausea and vomiting. Gastroenterology 1986; 90: 1919-25.
  • 4. Hyett B, Martinez FJ, Gill BM, Mehra S, Lembo A, Kelly CP, et al. Delayed radionucleotide gastric emptying studies predict morbidity in diabetics with symptoms of gastroparesis. Gastroenterology 2009;137:445-52.
  • 5. Maleki D, Locke GR III, Camilleri M, Zinsmeister AR, Yawn BP, Leibson C, et al. Gastrointestinal tract symptoms among persons with diabetes mellitus in the community. Arch Intern Med. 2000; 160: 2808-16.
  • 6. Bytzer P, Talley NJ, Leemon M, Young LJ, Jones MP, Horowitz M. Prevalence of gastrointestinal symptoms associated with diabetes mellitus: a population-based survey of 15,000 adults. Arch Intern Med. 2001; 161: 1989-96.
  • 7. Talley NJ, Bytzer P, Hammer J, Young L, Jones M, Horowitz M. Psychological distress is linked to gastrointestinal symptoms in diabetes mellitus. Am J Gastroenterol. 2001; 96: 1033-1038.
  • 8. Punkkinen J, Färkkilä M, Mätzke S, et al. Upper abdominal symptoms in patients with Type 1 diabetes: unrelated to impairment in gastric emptying caused by autonomic neuropathy. Diabet Med. 2008; 25: 570-7.
  • 9. Talley NJ, Young L, Bytzer P, Hammer J, Leemon M, Jones M, et al. Impact of chronic gastrointestinal symptoms in diabetes mellitus on health-related quality of life. Am J Gastroenterol. 2001; 96: 71-6.
  • 10. Rentz AM, Kahrilas P, Stanghellini V, Tack J, Talley NJ, de la Loge C, et al. Development and psychometric evaluation of the patient assessment of upper gastrointestinal symptom severity index (PAGI-SYM) in patients with upper gastrointestinal disorders. Qual Life Res. 2004; 13(10): 1737–49.
  • 11. Revicki DA, Rentz AM, Dubois D, Kahrilas P, Stanghellini V, Talley NJ, et al. Development and validation of a patient-assessed gastroparesis symptom severity measure: the Gastroparesis Cardinal Symptom Index. Aliment Pharmacol Ther. 2003; 18: 141–50.
  • 12. Revicki DA, Rentz AM, Dubois D, Kahrilas P, Stanghellini V, Talley NJ, et al. Gastroparesis Cardinal Symptom Index (GCSI): development and validation of a patient reported assessment of severity of gastroparesis symptoms. Qual Life Res. 2004; 13: 833– 44.
  • 13. de la Loge C, Trudeau E, Marquis P, Kahrilas P, Stanghellini V, Talley NJ, et al. Cross-cultural development and validation of a patient self-administered questionnaire to assess quality of life in upper gastrointestinal disorders: The PAGI-QOL. Qual Life Res. 2004; 13: 1751–62.
  • 14. Thomforde GM, Camilleri M, Phillips SF, Forstrom LA. Evaluation of an inexpensive screening scintigraphic test of gastric emptying. J Nucl Med. 1995; 36: 93–6.
  • 15. Tougas GH, Eaker EY, Abell TL, Abrahamsson H, Boivin M, Chen J, et al. Assessment of gastric emptying using a low fat meal: establishment of international control values. Am J Gastroenterol. 2000; 95: 1456 – 62.
  • 16. Jaffe JK, Paladugu S, Gaughan JP, Parkman HP. Characteristics of nausea and its effects on quality of life in diabetic and idiopathic gastroparesis. J Clin Gastroenterol. 2011; 45(4): 317-21.
  • 17. Cherian D, Parkman HP. Nausea and vomiting in diabetic and idiopathic gastroparesis. Neurogastroenterol Motil. 2012; 24(3): 217-22.
  • 18. Cherian D, Sachdeva P, Fisher RS, Parkman HP. Abdominal pain is a frequent symptom of gastroparesis. Clin Gastroenterol Hepatol. 2010; 8(8): 676-81.
  • 19. Hasler WL, Wilson LA, Parkman HP, et al. Factors related to abdominal pain in gastroparesis: contrast to patients with predominant nausea and vomiting. Neurogastroenterol Motil. 2013;25(5):427-38.
Toplam 19 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular İç Hastalıkları
Bölüm Araştırma Makalesi
Yazarlar

Özlem Özer Çakır

Gulsum Gönülalan

Murat Ismailoglu Bu kişi benim

Huseyin Ataseven Bu kişi benim

Ali Demir

Hakki Polat

Yayımlanma Tarihi 15 Aralık 2017
Gönderilme Tarihi 8 Eylül 2017
Kabul Tarihi 18 Eylül 2017
Yayımlandığı Sayı Yıl 2017 Cilt: 1 Sayı: 3

Kaynak Göster

Vancouver Özer Çakır Ö, Gönülalan G, Ismailoglu M, Ataseven H, Demir A, Polat H. Early satiation and nausea are independent determinants of poor quality of life in patients with type 2 diabetes mellitus with and without diabetic gastroparesis. Acta Med. Alanya. 2017;1(3):110-5.

9705 

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