The role of biologically active substances in gastroesophageal reflux disease in patients with type 2 diabetes mellitus

Abstract

Background. The factors influencing the progression and clinical manifestations of gastroesophageal reflux di­sease (GERD) in patients with type 2 diabetes mellitus (DM) have not been sufficiently studied so far. To investigate the features of changes in serum prostaglandin (Pg) І₂ and F_2α levels depending on the clinical course of GERD in patients with type 2 DM was the purpose of our work. Materials and methods. The study involved 82 patients with GERD and type 2 DM (main, group 1) and comparison group (85 individuals, group 2). Serum levels of prostaglandin PgF_2α and 6-keto-prostaglandin F_1α (blood prostacyclin — PgI₂) were evaluated in patients. Results. Digestive complaints characteristic of GERD have been detected in 61.0 % of persons from group 1, 22.0 % of individuals with combined pathology have been diagnosed with otolaryngologic form of GERD, and 17.1 % had a cardiac form. Patients with combined pathology have a more significant increase in the concentration of PgI₂ with extra-esophageal manifestations of GERD, especially with its otolaryngologic form (4.1 times higher than indicators of the control group), whereas in patients with cardiac mask of GERD, its concentration is increased 3.5-fold, and in those with esophageal manifestations of GERD and type 2 DM — 3-fold. In patients with GERD, similar changes were detected 2.4 times (otolaryngologic manifestations), 2.2 times (cardiac manifestations) and 1.6 times (typical manifestations of GERD) more often. Conclusions. GERD in patients with type 2 DM is often manifested by extravascular symptoms (otolaryngologic, cardiac form). The maximum increase in the level of serum prostacyclin is established in patients with extraesophageal manifestations of GERD and type 2 DM, especially with its otolaryngologic form.