Histological features of oesophagus mucous membrane changes in patients with gastroesophageal reflux disease and type 2 diabetes mellitus

Abstract

Introduction. The high medical and social significance of type 2 diabetes mellitus (T2DM) is not only due to its prevalence, but also to serious complications that lead to a decrease in the quality of patients’ life, early disability, and high mortality. The objective of the study was to evaluate the histological and morphometric features of the oesophagus mucous membrane in patients with gastroesophageal reflux disease (GERD) and T2DM compared to patients with GERD without T2DM. Material and methods. 67 patients with GERD and T2DM and 50 patients with GERD without T2DM, matched for age and sex, were examined. Comparative morphometry of histological changes of the oesophageal mucosa was performed. Results. The histological investigation showed that in patients of the main study group (with GERD and T2DM), almost all the studied parameters had a significantly more severe course and exceeded similar indicators of the group with isolated GERD: the thickness of the basal layer (1.86±0.04 points against 0.97±0.02 points), papillae height (1.71±0.06 points versus 0.72±0.07 points), inflammatory epithelial infiltration (1.88±0.03 points against 1.27±0.07 points), width of intercellular spaces (2.04±0.08 against 1.10±0.07 points) (p<0.01 in all cases). Conclusions. The inflammatory process in the oesophageal mucosae in patients with GERD without T2DM has a more superficial character and is limited mainly to the epithelial layer, whereas hyperplastic changes in the mucous membrane of the oesophagus are more pronounced in patients with GERD and T2DM.

Keywords

• gastroesophageal reflux disease
• type 2 diabetes mellitus
• oesophageal biopsy histological study