P0499 - Analysis of Variation in Interstitial Cells of Cajal Among Male and Females in Gastroparesis Patients With Different Etiologies: a Retrospective Cohort Study

Daniyal Raza, MD, Maryam Mubashir, MD, Lena Kawji, MD, Praveen Penagulari, MD, Michael Tran, MD, Michelle Neice, MD, Omar Khan, MD, Syed Musa Raza, MD, Shazia Rashid, MD, Britanny Pass, BS, Natalie Roppolo, MS, MD Ismail Hossain, , Mohammad Alfrad Nobel Bhuiyan, PhD, Qiang Cai, MD
LSU Health, Shreveport, LA

Introduction: Refractory gastroparesis is identified by the absence of response to dietary adjustments and an extended trial of maximally tolerated doses of prokinetic medications lasting over six months. Effectively managing refractory gastroparesis presents challenges, and the use of G-POEM (Gastric Per Oral Endoscopic Myotomy) has shown promising results as a therapeutic intervention. G-POEM additionally enables a direct biopsy of the gastric muscle, which is the location of the pacemaker cells known as the ICC (interstitial cells of Cajal). Earlier studies suggested a decrease in ICC cells in animal models with delayed gastric emptying and patients diagnosed with gastroparesis. However, the potential differences in ICC cell numbers between male and female gastroparesis patients with diverse etiologies remain unexplored.

Methods: Patients with confirmed gastroparesis diagnoses who underwent planned G-POEM procedures at two institutions* during two distinct time periods (August 2019-December 2019 and September 2022-November 2023) were included in this study. The ICC in gastric antral muscle samples were examined and quantitated in a 4 mm² piece. Statistical significance in ICC between male and female gastroparesis patients with different etiologies, including diabetes, post-surgical, and idiopathic causes, was determined using a two-sample T-test.

Results: In this study, 84 participants with an average age of 48.6 years were included, comprising 77.6% females, with 17.6% aged 65 or older. Diabetic gastroparesis was present in 47.6%, post-surgical gastroparesis in 16.7%, and idiopathic gastroparesis in 35.7% of the patients. Distinct gender distributions were observed within each etiological group: 25% males and 75% females in the diabetic group, 21.4% males and 78.6% females in post-surgical gastroparesis, and 16.7% males and 83.3% females in idiopathic gastroparesis. The distribution of ICC cell numbers among males and females with different etiologies is illustrated in Figure 1, revealing a significant difference in ICC cells between males (688) and females (365) in the diabetic group (P-value of 0.02). No statistically significant difference was observed in male and female ICC cells in the post-surgical and idiopathic etiologies.

Discussion: The lower ICC cell count in females with diabetes may explain the predominance of gastroparesis among females, but larger-scale studies are needed for validation.



Disclosures:


Daniyal Raza, MD, Maryam Mubashir, MD, Lena Kawji, MD, Praveen Penagulari, MD, Michael Tran, MD, Michelle Neice, MD, Omar Khan, MD, Syed Musa Raza, MD, Shazia Rashid, MD, Britanny Pass, BS, Natalie Roppolo, MS, MD Ismail Hossain, , Mohammad Alfrad Nobel Bhuiyan, PhD, Qiang Cai, MD. P0499 - Analysis of Variation in Interstitial Cells of Cajal Among Male and Females in Gastroparesis Patients With Different Etiologies: a Retrospective Cohort Study, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.