J Neurogastroenterol Motil  https://doi.org/10.5056/jnm19037
Association Between Gastric Emptying Time and Incidence of Cardiovascular Diseases in Subjects With Diabetes
Hyung-Min Park, Seon-Young Park,* Jin Ook Chung,* Dong Hyuk Cho, Chang-Hwan Park, Hyun-Soo Kim, Dong Jin Chung, Sung-Kyu Choi, Jong-Sun Rew, and Min Young Chung
Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea
Correspondence to: Seon-Young Park and Jin Ook Chung are equally responsible for this study.
Seon-Young Park, MD, PhD
Chonnam National University Medical School, 160, Baekseo-ro, Dong-gu, Gwangju, Korea
Tel: +82-62-220-6296, Fax: +82-62-225-8578, E-mail: drpsy@naver.com
Jin Ook Chung, MD, PhD
Chonnam National University Medical School, 160, Baekseo-ro, Dong-gu, Gwangju, Korea
Tel: +82-62-220-6296, Fax: +82-62-225-8578, E-mail: imagine-jjo@hanmail.net
Received: February 14, 2019; Revised: April 11, 2019; Accepted: May 6, 2019; Published online: May 22, 2019.
© The Korean Society of Neurogastroenterology and Motility. All rights reserved.

cc This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Delayed gastric emptying (GE) is associated with high morbidity and mortality in subjects with diabetes. The aim of this study is to investigate associations between GE time and the major cardiovascular events (coronary heart diseases and ischemic stroke) in diabetic subjects with upper gastrointestinal (UGI) symptoms.
Among 259 subjects with chronic UGI symptoms who underwent gastric emptying study (GES) over 13 years, 122 diabetic subjects without gastric surgery and/or rapid GE were enrolled in this study. We also gathered data about baseline demographics, clinical characteristics, estimated GE half-time (GE T½) and incidence of cardiovascular events following GES.
The mean age of subjects was 64.0 ± 17.4 years. There were 86 women and 104 subjects with type 2 diabetes. There were 52 (42.6%) subjects with normal GE, 50 (41.0.%) subjects with mild delayed GE, and 20 (16.4%) subjects with marked delayed GE. During follow-up (median, 207 weeks), cardiovascular events occurred in 7 (13.5%) subjects with normal GE, 4(8.0%) subjects with mild delayed GE and 7 (35.0%) subjects with marked GE (P = 0.015). Univariate analysis showed that GE T½ was significantly associated with incidence of cardiovascular events (crude OR, 1.74; 95% CI, 1.12-2.69; P = 0.014). In a multivariate model, association between GE T½ and incidence of cardiovascular events remained statistically significant after adjustment for baseline characteristics and comorbidities (adjusted OR, 1.94; 95% CI, 1.21-3.12; P = 0.006).
A delay of GE was associated with an increased incidence of cardiovascular events in diabetic subjects with chronic UGI symptoms.
Keywords: Coronary disease; Diabetes Mellitus; Emptying, gastric; Stroke

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