Table 4.
Multivariable logistic regression analysis for characteristics independently associated with gastroparesis etiology
| Diabetes Type 1 Vs Idiopathic* |
Diabetes Type 2 Vs Idiopathic* |
|||||
|---|---|---|---|---|---|---|
| Odds | P | Odds | P | |||
| Characteristics Selected | Ratios† | 95% CI | value | Ratios† | 95% CI | value |
| Demographic: | ||||||
| Gender: female | 2.27 | 1.05–4.91 | 0.04 | n/s | n/s | n/s |
| White, non-Hispanic | 0.32 | 0.15–0.68 | 0.004 | 0.23 | 0.09–0.54 | 0.001 |
| Anthropometric: | ||||||
| Overweight‡ | n/s | n/s | n/s | 5.45 | 2.34–12.69 | <0.001 |
| Symptoms: | ||||||
| Age at symptom onset: | ||||||
| < 25 years-45 years | n/s | 1.00 | ||||
| > 45 years | n/s | n/s | n/s§ | 3.64 | 1.78–7.46 | <0.001 |
| PAGI-SYM symptom severity‡ | ||||||
| Retching severity | n/s | n/s | n/s | 1.26 | 1.01–1.58 | 0.04 |
| Inability to finish meal | 0.76 | 0.59–0.96 | 0.02 | n/s | n/s | n/s |
| Lower abdominal pain severity | n/s | n/s | n/s | 0.66 | 0.51–0.86 | 0.002 |
| Gastric emptying scintigraphy: | ||||||
| Severity gastric retention 4 hr: | 0.001 | n/s | ||||
| Mild (0% – 20%) | 1.00 | n/s | ||||
| Moderate (21% – 35%) | 3.53 | 1.49–9.34 | 0.004 | n/s | n/s | n/s |
| Severe (> 35%) | 4.44 | 1.97–9.98 | <0.001 | n/s | n/s | n/s |
| Treatment & hospitalizations: | ||||||
| Currently takes prokinetics | 2.07 | 1.06–4.01 | 0.03 | n/s | n/s | n/s |
| Has gastric electric stimulation | 3.69 | 1.31–10.42 | 0.01 | n/a | n/a | n/a |
| Number of hospitalizations in past year | 1.16 | 1.08–1.25 | <0.001 | n/s | n/s | n/s |
| Psychological function & QOL: | ||||||
| PAGI-QOL Activity sub-score‡ | n/s | n/s | n/s | 2.75 | 1.64–4.65 | <0.001 |
| PAGI-QOL Diet sub-score‡ | 1.60 | 1.17–2.20 | 0.003 | n/s | n/s | n/s |
| SF-36 physical health summary score‡ | n/s | n/s | n/s | 0.88 | 0.83–0.93 | <0.001 |
| SF-36 mental health summary score‡ | 0.96 | 0.93–0.99 | 0.01 | 0.93 | 0.89–0.97 | 0.001 |
Gastroparesis etiology derived using response to the main reason for gastroparesis evaluation and report of diagnosed diabetes: idiopathic must have no prior history of diabetes: Diabetes type 1 (T1DM) (N=78), Diabetes type 2 (T2DM) (N=58), idiopathic (253 in T1DM analyses, 254 in T2DM analyses)
Independent characteristics and associated odds ratios and 95% confidence intervals (CI) were determined from fitting the pooled set of characteristics with significance at the 0.05 level from bi-directional multivariable logistic regression analysis for each sub-group (T1DM and idiopathic, T2DM and idiopathic).
n/a = Characteristic not in model due to instability of model because of multicollinearity
n/s = Characteristic not significant at the 0.05 level
If a characteristic in the full candidate set was not significant in either of the 2 models, then it was not presented in the table, i.e., Hispanic (yes vs no), married or not, college education (yes vs no), currently work, usual occupation (laborer, professional, other), income≥$50K, duration of gastroparesis symptoms at study enrollment, initial infectious prodrome, predominant symptom prompting gastroparesis evaluation (nausea, vomiting, abdominal pain or other), acute symptom onset (versus insidious), gastroparesis severity, PAGI-SYM severity scores: (nausea, vomiting, fullness, excessively full after meal, appetite loss, bloating, distended stomach, upper abdominal pain, GERD sub-scale, constipation, diarrhea severity), currently take proton pump inhibitors, anti-emetics, any NASI, any narcotics, pain modulators, antidepressants, any anxiolytics, any hormones, any hospitalization in past year, number of comorbidities, ever diagnosed with major depression or anxiety, State or Trait Anxiety Inventory score≥50, BDI>28, PAGI-QOL:(clothing, relationship, psychological subscores).
GCSI was not significant in either model.
Definitions:
Overweight or obese (BMI > 25 kg/m2)
Symptom severity scores from the PAGI-SYM (Patient Assessment of GI Symptoms) questionnaire, scores range from 0–5
GERD severity sub-scale = average of the sum of heartburn day, heartburn lying down, chest discomfort during the day, chest discomfort during the night, reflux during the day, reflux during the night, and bitter taste severity scores
Subscales derived from the Patient Assessment of Upper Gastrointestinal Disorders-Quality of Life (PAGI-QOL). Scales have been recoded so that a higher score reflects a higher QOL.
SF-36v2 Health Survey scores standardized to 1998 U.S. general population with a mean (± SD) of 50± 10, in which a higher score reflects a better health outcome.
Though statistically insignificant, odds ratios and P values determined in the T1DM model using Age at symptom onset: 25–45 yrs, 45+ years compared to < 25 years. The 2 category variable was used in the T2DM model due to insufficient numbers in the <25 years category.