Su1436 Central Versus Peripheral Sites of Action of New Ghrelin Agonists on Gastrointestinal Prokinetic Activity

Abstract

Background: Gastric dysmotility including delayed gastric emptying and decrease the electrical activity of the stomach is common in patients with long-standing diabetes mellitus (DM). These DM patients, some of them are diagnosed as diabetic gastroparesis, have several upper gastrointestinal (GI) symptoms such as nausea, vomiting, bloating and abdominal pain. However, the relationship between gastric dysmotility and GI symptoms has not been investigated well. Aim: The aim of this study was to identify the relationship between gastric motility measures and upper GI symptoms in patients with long-standing DM. Methods: We enrolled 22 long-standing DM patients (13 females, 9 males; aged 33-80 years) with more than 10 years duration of DM, and 15 matched healthy controls (9 females, 6 males; aged 26-74 years). All DM patients were receiving insulin treatment, and had at least one history of diabetic neuropathy, retinopathy or nephropathy. Gastric motility was evaluated with cutaneous recorded electrogastrography (EGG) and gastric emptying of a semi-solid meal, using 13C-octanoic acid breath testing. Upper GI symptoms were quantified in all patients by questionnaire. Results: Compared with the healthy controls, the DM patients showed a significant lower percentage of normogastria (2to 4 cpm slow wave) in both fasting and postprandial state with a lower power ratio (postprandial peak power / fasting peak power) in EGG. Both half-emptying time and lag time in 13C-acetic acid breath testing were higher in DM patients than in healthy controls, indicating that gastric emptying was significantly delayed in the former in overall analysis. Fifteen patients demonstrated abnormalities of either gastric myoelectric activity or gastric emptying (group A), and 7 had normal gastric motor function (group B). Sixteen of 22 (72.7%) patients had some kind of upper GI symptoms. The number of patients who had some GI symptoms was 13 in group A versus 3 in group B. No significant correlation was observed between gastric emptying parameters and HbA1C values. Conclusion: The patients with long-standing DM showed gastric dysmotility, including impaired gastric myoelectrical activity and delayed gastric emptying. Gastric dysmotility appear to be an important factor in the generation of upper GI symptoms in patients with long-standing DM. The relationship between gastric motility and upper gastrointestinal symptoms