DIURNAL PROFILE OF GASTRIC ACIDITY AND ITS CHRONOLOGICAL STRUCTURE IN PATIENTS WITH METABOLIC SYNDROME

Abstract

Abstract. Introduction. Gastrointestinal tract (GIT) is of principal importance for metabolic diseases. Several GIT-related mechanisms that potentially contribute to the metabolic syndrome are known [1]. Nonetheless, the gastric acid secretion in these patients is still under-investigated. The aim of this study was to determine the gastric acid secretion peculiarities in patients with Metabolic syndrome (MS). Materials and methods. 50 patients diagnosed with MS and 50 patients without MS were included in this study. Of the 50 patients in the MS group – 15 were found to have pathological acid GERD. Patients with GERD were compared with patients with MS but without GERD. Topographical and 24-hours gastric pH metry was performed with the help of АГ-1рН-М computer acidogastrograph. Results. According to the topographic pH metry performed during EGD patients with MS were less likely to have hyperacidity compared to patients without MS (p<0,05), while hypoacidic conditions were more common (p<0,05). Direct correlation was present between gastric pH and duration of MS and diabetes mellitus(p<0,05). When assessing the stomach antrum alkalizing function, patients with MS were mostly found to have subcompensated function, while it was preserved in most patients without MS. However, among patients with MS, decompensated alkalizing function was probably less common compared to non-MS patients (p<0,05). 24-hours pH monitoring showed that in non-MS patients the gastric pH was probably lower than the same indicators in MS group in the period from 2 to 5 am and in the period from 7 to 8 am. Moreover, the pH values were below the limit value of 4 throughout the day in non-MS group, while in patients with MS pH values above 4 were maintained in 29,2% of the 24-hour period, mainly at night. Distribution by sex was similar in both groups but obesity (p<0.05) and overweight (p<0.05) were more common in the GERD patients vs non-GERD patients in MS group. Conclusions. In MS patients gastric hypoacidity is more common than in non-MS patients despite the preserved acid secretion function. While pH values above 4 were maintained in 29,2% of the 24-hour period, the duration of acid-suppressive drug action may not exceed 17 hours, while for patients without MS such duration of acid suppression is insuf􀏐icient. A direct correlation between gastric pH and both MS and diabetes mellitus duration was found. GERD was diagnosed in 30% of patients with MS, they were older and more often obese or with overweight. Key words: chronological structure, GERD, metabolic syndrome, pH-metry, obese, overweight.