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Gastroesophageal Reflux Disease is Inversely Related with Glycemic Control in Morbidly Obese Patients

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Abstract

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 ± 3 mmHg; P = 0.050); lower ventilatory gradient (inspiratory–expiratory GEPG, 10.9 ± 3.8 vs. 13.6 ± 4.1 mmHg; P = 0.012); lower waist-to-hip 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.

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Conflict of Interest Statement

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Programa de Pós-Graduação: Ciências em Gastroenterologia, Faculdade de Medicina, UFRGS, Porto Alegre-RS, Brazil

    Adriana Lauffer, Cassiano Mateus Forcelini & Fernando Fornari

  2. Faculdade de Medicina, Universidade de Passo Fundo, Teixeira Soares, 817, 99010-080, Passo Fundo-RS, Brazil

    Cassiano Mateus Forcelini, Liana Ortiz Ruas, Carlos Augusto Scussel Madalosso & Fernando Fornari

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  1. Adriana Lauffer
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  2. Cassiano Mateus Forcelini
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  3. Liana Ortiz Ruas
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  4. Carlos Augusto Scussel Madalosso
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  5. Fernando Fornari
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Correspondence to Fernando Fornari.

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Lauffer, A., Forcelini, C.M., Ruas, L.O. et al. Gastroesophageal Reflux Disease is Inversely Related with Glycemic Control in Morbidly Obese Patients. OBES SURG 21, 864–870 (2011). https://doi.org/10.1007/s11695-011-0372-7

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