Retrospective Study
Copyright ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Hepatol. Jul 27, 2025; 17(7): 109067
Published online Jul 27, 2025. doi: 10.4254/wjh.v17.i7.109067
Analysis of gastric electrical rhythm in patients with metabolic dysfunction-associated steatotic liver disease and type 2 diabetes mellitus
Xi-Xi Wang, Chun Yan, Su-Juan Wang, Hong Zhu, Chang-Chun Cao, Li Wu, Shuang Wang, Ji Hu, Hong-Hong Zhang
Xi-Xi Wang, Hong Zhu, Chang-Chun Cao, Li Wu, Shuang Wang, Department of Endocrinology, The Affiliated Suqian Hospital of Xuzhou Medical University, Suqian 223800, Jiangsu Province, China
Chun Yan, Ji Hu, Department of Endocrinology, The Second Affiliated Hospital of Soochow University, Suzhou 215000, Jiangsu Province, China
Su-Juan Wang, Department of Gastroenterology, Sihong Hospital, Suqian 223800, Jiangsu Province, China
Hong-Hong Zhang, Clinical Research Center of Neurological Disease, Department of Endocrinology, The Second Affiliated Hospital of Soochow University, Suzhou 215000, Jiangsu Province, China
Co-first authors: Xi-Xi Wang and Chun Yan.
Co-corresponding authors: Ji Hu and Hong-Hong Zhang.
Author contributions: Wang XX, Wang SJ, and Yan C collected and analyzed the data and wrote the article; Zhu H, Cao CC, Wu L and Wang S collected and analyzed the data; Hu J reviewed and edited the article; Zhang HH designed and supervised the study and edited the article, Zhang HH is the guarantor of this study and, as such, had full access to all the data in the study and takes responsibility for the authenticity of the data and the accuracy of the data analysis; Hu J and Zhang HH have played important and indispensable roles in the experimental design, data interpretation and manuscript preparation as the co-corresponding authors.
Supported by Noncommunicable Chronic Diseases-National Science and Technology Major Project, No. 2023ZD0507200; The Suqian Sci Tech Program, No. Z2023106; National Natural Science Foundation of China, No. 82071234, No. 31400947 and No. 82170836; Gusu Talent Program, No. GSWS2022030; and The Clinical Research Center of Neurological Disease of The Second Affiliated Hospital of Soochow University, No. ND2024A02.
Institutional review board statement: The protocol of the present study was approved by the Institutional Review Board of the Second Affiliated Hospital of Soochow University and the Affiliated Suqian Hospital of Xuzhou Medical University, and the approving registration number is JD-HG-2022-07 and 2024036.
Informed consent statement: Informed Consent was not required for this retrospective study.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: No additional data are available.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Hong-Hong Zhang, Professor, Clinical Research Center of Neurological Disease, Department of Endocrinology, The Second Affiliated Hospital of Soochow University, No. 1055 Sanxiang Road, Suzhou 215000, Jiangsu Province, China. zhanghonghong@suda.edu.cn
Received: May 19, 2025
Revised: June 4, 2025
Accepted: July 8, 2025
Published online: July 27, 2025
Processing time: 68 Days and 19.6 Hours
Abstract
BACKGROUND

Diabetic gastrointestinal autonomic neuropathy (DGAN) often affects the patients’ quality of life. Thus, research on influencing factors of DGAN may promote DGAN prevention and decrease the incidence rate. This study used electrogastrogram (EGG) to assess the relationship between metabolic dysfunction-associated steatotic liver disease (MASLD) and DGAN.

AIM

To analyze the changes of EGG in patients with MASLD and type 2 diabetes mellitus (T2DM), and to elucidate whether ultrasound-diagnosed MASLD is an independent risk factor for diabetic gastric motility disorders (DGMD).

METHODS

A total of 272 patients with T2DM hospitalized at the Second Affiliated Hospital of Soochow University from December 2020 to December 2021 and the Affiliated Suqian Hospital of Xuzhou Medical University from November 2023 to June 2024 were included in the cross-sectional study. General information, clinical data, and medical history of all study subjects, including name, age, gender, body mass index, and duration of diabetes were collected. Laboratory tests included biochemical parameters, glycosylated hemoglobin (HbA1c), fasting C-peptide, 2h postprandial C-peptide and 25-hydroxyvitamin D [25(OH)D]. EGG, fundus examination and carotid artery ultrasonography were performed and results were recorded. According to the results of EGG, the subjects were divided into the DGMD group and non-DGMD group.

RESULTS

The duration of diabetes, fasting blood glucose (FBG), HbA1c, 25(OH)D and the prevalence of MASLD were significantly higher in the DGMD group (P < 0.05). Multiple logistic regression analysis showed that the duration, FBG, 25(OH)D and the presence of MASLD were independent influencing factors.

CONCLUSION

MASLD is strongly associated with an increased incidence of DGMD. Timely treatment of MASLD is effective to prevent diabetic gastroparesis.

Keywords: Type 2 diabetes mellitus; Gastric electrical rhythm; Electrogastrogram; Metabolic dysfunction-associated steatotic liver disease; Diabetic gastric motility disorders

Core Tip: This study identifies metabolic dysfunction-associated steatotic liver disease (MASLD) as an independent risk factor for diabetic gastric motility disorders (DGMD) in type 2 diabetes patients, confirmed by electrogastrogram. Longer diabetes duration, elevated fasting blood glucose, and lower 25-hydroxyvitamin D levels synergistically increase DGMD risk. Early intervention for MASLD may prevent diabetic gastroparesis.