Gastroesophageal Reflux Disease is Inversely Related with Glycemic Control in Morbidly Obese Patients
- نوع فایل : کتاب
- زبان : انگلیسی
- مؤلف : Adriana Lauffer & Cassiano Mateus Forcelini & Liana Ortiz Ruas & Carlos Augusto Scussel Madalosso & Fernando Fornari
- چاپ و سال / کشور: 2011
Description
Background The link between diabetes mellitus and gastroesophageal reflux disease (GERD) is controversial. We assessed the relationship between glycemic control (GC) and GERD in morbidly obese patients. Methods Consecutive patients with morbid obesity (n=86) underwent manometry, pH-metry, endoscopy, and contrasted X-ray after responding to a GERD questionnaire and dosing fasting plasma glucose (FPG) and glycated hemoglobin (HbA1c). Patients with poor GC (HbA1c, 6.1– 10% and FPG<140 mg/dl) and those with very poor GC (HbA1c>10% or FPG>140 mg/dl) were compared. Results There were 63 patients with poor GC and 17 with very poor GC. Compared to patients with very poor GC, patients with poor GC showed higher heartburn scores [8 (0– 12) vs. 0 (0–4); P=0.003]; higher total esophageal acid exposure [5.2% (2.5–10.5%) vs. 2.3% (0.8–7.5%); P=0.041]; lower distal esophageal amplitude (105±38 vs. 134± 63 mmHg; P=0.019); higher expiratory gastroesophageal pressure gradient (GEPG, 7±3.4 vs. 5.2±3mmHg; P=0.050); lower ventilatory gradient (inspiratory–expiratory GEPG, 10.9±3.8 vs. 13.6±4.1 mmHg; P=0.012); lower waist-tohip ratio (0.95 vs. 1; P=0.040); and more hiatal hernia (38% vs. 6%; P=0.016). Conclusions This study suggests an inverse relation between glycemic control and GERD in morbidly obese patients. This can be partially explained by a lower frequency of hiatal hernia in patients with very poor glycemic control.
OBES SURG (2011) 21:864–870 DOI 10.1007/s11695-011-0372-7 Published online: 18 February 2011
