Autonomic and enteric function profiling can predict disordered gastric emptying in diabetic gastropathy

Area of Science:

• Gastroenterology
• Diabetology
• Autonomic Neurology

Background:

• Gastric emptying tests (GET) diagnose gastroparesis, but many patients lack delayed emptying.
• Diabetic gastropathy is a common complication of diabetes mellitus.
• Accurate prediction of disordered gastric emptying is crucial for patient management.

Purpose of the Study:

• To evaluate the combination of autonomic nervous system (ANS) testing and electrogastrography (EGG) in predicting disordered GET.
• To determine if ANS and EGG measures can improve the prediction of gastric emptying abnormalities in diabetic patients.

Main Methods:

• Seventy-six diabetic patients underwent ANS testing (PAR, VC, RRI) and cutaneous EGG.
• Solid GET was assessed, with subgroups based on 50% emptying time (TS50).
• Linear and ordinal logistic regression analyses were used to correlate ANS/EGG measures with GET TS50.

Main Results:

• Autonomic function tests (VC, PAR) and EGG showed significant inverse correlation with GET TS50.
• RRI and EGG predicted gastric emptying, with higher values linked to rapid emptying.
• The combined four-component model (RRI, VC, PAR, EGG) demonstrated superior predictive capability (AUROC 0.72) compared to EGG alone (0.59).

Conclusions:

• A combination of RRI, VC, PAR, and EGG quantitatively describes gastric emptying in diabetic gastropathy.
• This multi-component approach offers a more accurate prediction of disordered gastric emptying than EGG alone.
• These findings support the use of ANS and EGG testing for diagnosing gastroparesis in diabetic patients.