Ford Alexander C, Forman David, Bailey Alastair G, Axon Anthony T R, Moayyedi Paul
Department of Academic Medicine, Clinical Sciences Building, St James's University Hospital, Leeds, UK.
Gut. 2007 Mar;56(3):321-7. doi: 10.1136/gut.2006.099846. Epub 2006 Aug 14.
Numerous studies examining the prevalence and natural history of dyspepsia in the general population have been conducted. However, few have reported the effect of quality of life on the development of dyspepsia. A 10-year longitudinal follow-up study examining the effect of quality of life on subsequent dyspepsia was performed.
Individuals originally enrolled in a population-screening programme for Helicobacter pylori were contacted through a validated postal dyspepsia questionnaire. Baseline demographic data, quality of life at original study entry, and dyspepsia and irritable bowel syndrome (IBS) symptom data were already on file. Consent to examine primary-care records was sought, and data regarding non-steroidal anti-inflammatory drugs (NSAID) and aspirin use were obtained from these.
Of 8407 individuals originally involved, 3912 (46.5%) provided symptom data at baseline and 10-year follow-up. Of 2550 (65%) individuals asymptomatic at study entry, 717 (28%) developed new-onset dyspepsia at 10 years, an incidence of 2.8% per year. After multivariate logistic regression, lower quality of life at study entry (OR 2.63; 99% CI 1.86 to 3.71), higher body mass index (OR per unit 1.05; 99% CI 1.02 to 1.08), presence of IBS at study entry (OR 3.1; 99% CI 1.51 to 6.37) and use of NSAIDs and/or aspirin (OR 1.32; 99% CI 0.99 to 1.75) were significant risk factors for new-onset dyspepsia.
The incidence of new-onset dyspepsia was almost 3% per year. Low quality of life at baseline exerted a strong effect on the likelihood of developing dyspepsia at 10 years.
已经开展了大量研究来调查普通人群中消化不良的患病率和自然病史。然而,很少有研究报告生活质量对消化不良发展的影响。我们进行了一项为期10年的纵向随访研究,以考察生活质量对后续消化不良的影响。
通过一份经过验证的邮寄消化不良问卷,联系最初参加幽门螺杆菌人群筛查项目的个体。基线人口统计学数据、最初研究入组时的生活质量、消化不良和肠易激综合征(IBS)症状数据已存档。寻求查阅初级保健记录的同意书,并从这些记录中获取有关非甾体抗炎药(NSAID)和阿司匹林使用的数据。
在最初参与的8407名个体中,3912名(46.5%)在基线和10年随访时提供了症状数据。在研究入组时无症状的2550名(65%)个体中,717名(28%)在10年后出现新发消化不良,年发病率为2.8%。经过多变量逻辑回归分析,研究入组时生活质量较低(比值比2.63;99%置信区间1.86至3.71)、体重指数较高(每单位比值比1.05;99%置信区间1.02至1.08)、研究入组时存在IBS(比值比3.1;99%置信区间1.51至6.37)以及使用NSAIDs和/或阿司匹林(比值比1.32;99%置信区间0.99至1.75)是新发消化不良的显著危险因素。
新发消化不良的年发病率近3%。基线时生活质量较低对10年后发生消化不良的可能性有很大影响。