Damage of autonomic nerve function in diabetic patients with gastrointestinal symptoms / 中华全科医师杂志

ABSTRACT

Objective To observe autonomic nerve function damage in diabetic patients with gastrointestinal symptoms. Methods Twenty-four patients of diabetes mellitus (DM) with gastrointestinal symptoms, as well as 20 cases of DM without gastrointestinal symptoms and 17 health volunteers were recruited from the clinic of gastroenterology, Jishuitan Hospital, Beijing during December 2008 to May 2009, and standard cardiovascular reflex test was performed for all of them to determine their functions of the autonomic nerve. Results Respiratory rate (an indicator of parasympathetic nerve function) was ( 14 ± 5 ) times per minute in patients of DM without dyspepsia, obviously lower than that in healthy controls [(20±10) times per minute], and that in patients of DM with dyspepsia was (9 ±6) times per minute, obviously lower than that in healthy controls and asymptomatic ones ( P ＜ 0. 05 ). Scores of five indicators of the autonomic nerve functions, and the sympathetic, parasympathetic nerve and overall autonomic nerve functions were significantly higher in patients of DM with gastrointestinal symptoms than those in the patients without dyspepsia and healthy controls. Abnormality rate of autonomic nerve functions was 96 percent (23/24) in the patients with dyspepsia, 58 percent (14/24) in those definitely and seriously involved, and five percent (1/20) in those without dyspepsia. Conclusions Autonomic neuropathy exists in most diabetic patients with dyspepsia, both sympathetic and parasympathetic nerve involved. Impairment of parasympathetic nerve function occurs earlier than that of sympathetic nerve in patients of DM.