进食障碍患者功能性消化不良及其亚型的患病率。

Prevalence of functional dyspepsia and its subgroups in patients with eating disorders.

机构信息

Department of Clinical and Experimental Medicine, University of Naples, Federico II, 80131 Naples, Italy.

出版信息

World J Gastroenterol. 2012 Aug 28;18(32):4379-85. doi: 10.3748/wjg.v18.i32.4379.

DOI:10.3748/wjg.v18.i32.4379

PMID:22969202

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3436054/

Abstract

AIM

To study the prevalence of functional dyspepsia (FD) (Rome III criteria) across eating disorders (ED), obese patients, constitutional thinner and healthy volunteers.

METHODS

Twenty patients affected by anorexia nervosa, 6 affected by bulimia nervosa, 10 affected by ED not otherwise specified according to diagnostic and statistical manual of mental disorders, 4th edition, nine constitutional thinner subjects and, thirty-two obese patients were recruited from an outpatients clinic devoted to eating behavior disorders. Twenty-two healthy volunteers matched for age and gender were enrolled as healthy controls. All participants underwent a careful clinical examination. Demographic and anthropometric characteristics were obtained from a structured questionnaires. The presence of FD and, its subgroups, epigastric pain syndrome and postprandial distress syndrome (PDS) were diagnosed according to Rome III criteria. The intensity-frequency score of broader dyspeptic symptoms such as early satiety, epigastric fullness, epigastric pain, epigastric burning, epigastric pressure, belching, nausea and vomiting were studied by a standardized questionnaire (0-6). Analysis of variance and post-hoc Sheffè tests were used for comparisons.

RESULTS

90% of patients affected by anorexia nervosa, 83.3% of patients affected by bulimia nervosa, 90% of patients affected by ED not otherwise specified, 55.6% of constitutionally thin subjects and 18.2% healthy volunteers met the Postprandial Distress Syndrome Criteria (χ(2), P < 0.001). Only one bulimic patient met the epigastric pain syndrome diagnosis. Postprandial fullness intensity-frequency score was significantly higher in anorexia nervosa, bulimia nervosa and ED not otherwise specified groups compared to the score calculated in the constitutional thinner group (4.15 ± 2.08 vs 1.44 ± 2.35, P = 0.003; 5.00 ± 2.45 vs 1.44 ± 2.35, P = 0.003; 4.10 ± 2.23 vs 1.44 ± 2.35, P = 0.002, respectively), the obese group (4.15 ± 2.08 vs 0.00 ± 0.00, P < 0.001; 5.00 ± 2.45 vs 0.00 ± 0.00, P < 0.001; 4.10 ± 2.23 vs 0.00 ± 0.00, P < 0.001, respectively) and healthy volunteers (4.15 ± 2.08 vs 0.36 ± 0.79, P < 0.001; 5.00 ± 2.45 vs 0.36 ± 0.79, P < 0.001; 4.10 ± 2.23 vs 0.36 ± 0.79, P < 0.001, respectively). Early satiety intensity-frequency score was prominent in anorectic patients compared to bulimic patients (3.85 ± 2.23 vs 1.17 ± 1.83, P = 0.015), obese patients (3.85 ± 2.23 vs 0.00 ± 0.00, P < 0.001) and healthy volunteers (3.85 ± 2.23 vs 0.05 ± 0.21, P < 0.001). Nausea and epigastric pressure were increased in bulimic and ED not otherwise specified patients. Specifically, nausea intensity-frequency-score was significantly higher in bulimia nervosa and ED not otherwise specified patients compared to anorectic patients (3.17 ± 2.56 vs 0.89 ± 1.66, P = 0.04; 2.70 ± 2.91 vs 0.89 ± 1.66, P = 0.05, respectively), constitutional thinner subjects (3.17 ± 2.56 vs 0.00 ± 0.00, P = 0.004; 2.70 ± 2.91 vs 0.00 ± 0.00, P = 0.005, respectively), obese patients (3.17 ± 2.56 vs 0.00 ± 0.00, P < 0.001; 3.17 ± 2.56 vs 0.00 ± 0.00, P < 0.001 respectively) and, healthy volunteers (3.17 ± 2.56 vs 0.17 ± 0.71, P = 0.002; 3.17 ± 2.56 vs 0.17 ± 0.71, P = 0.001, respectively). Epigastric pressure intensity-frequency score was significantly higher in bulimic and ED not otherwise specified patients compared to constitutional thin subjects (4.67 ± 2.42 vs 1.22 ± 1.72, P = 0.03; 4.20 ± 2.21 vs 1.22 ± 1.72, P = 0.03, respectively), obese patients (4.67 ± 2.42 vs 0.75 ± 1.32, P = 0.001; 4.20 ± 2.21 vs 0.75 ± 1.32, P < 0.001, respectively) and, healthy volunteers (4.67 ± 2.42 vs 0.67 ± 1.46, P = 0.001; 4.20 ± 2.21 vs 0.67 ± 1.46, P = 0.001, respectively). Vomiting was referred in 100% of bulimia nervosa patients, in 20% of ED not otherwise specified patients, in 15% of anorexia nervosa patients, in 22% of constitutional thinner subjects, and, in 5.6% healthy volunteers (χ(2), P < 0.001).

CONCLUSION

PDS is common in eating disorders. Is it mandatory in outpatient gastroenterological clinics to investigate eating disorders in patients with PDS?

摘要

目的

研究罗马 III 标准下功能性消化不良（FD）在进食障碍（ED）、肥胖患者、体质瘦弱者和健康志愿者中的流行情况。

方法

从一个专门研究进食行为障碍的门诊中招募了 20 名神经性厌食症患者、6 名神经性贪食症患者、10 名未特定的 ED 患者、9 名体质瘦弱者和 32 名肥胖患者。22 名年龄和性别匹配的健康志愿者被纳入健康对照组。所有参与者都接受了详细的临床检查。从结构化问卷中获得人口统计学和人体测量特征。根据罗马 III 标准，诊断 FD 及其亚组，即上腹疼痛综合征和餐后不适综合征（PDS）。通过标准化问卷（0-6）研究更广泛的消化不良症状，如早饱、上腹饱胀、上腹疼痛、上腹烧灼感、上腹压迫感、呃逆、恶心和呕吐的强度-频率评分。使用方差分析和事后 Sheffè 检验进行比较。

结果

90%的神经性厌食症患者、83.3%的神经性贪食症患者、90%的未特定的 ED 患者、55.6%的体质瘦弱者和 18.2%的健康志愿者符合餐后不适综合征标准（χ(2)，P<0.001）。只有 1 名贪食症患者符合上腹疼痛综合征诊断。与体质瘦弱者组相比，神经性厌食症、神经性贪食症和未特定的 ED 患者的餐后饱胀强度-频率评分明显更高（4.15±2.08 比 1.44±2.35，P=0.003；5.00±2.45 比 1.44±2.35，P=0.003；4.10±2.23 比 1.44±2.35，P=0.002，分别），肥胖组（4.15±2.08 比 0.00±0.00，P<0.001；5.00±2.45 比 0.00±0.00，P<0.001；4.10±2.23 比 0.00±0.00，P<0.001，分别）和健康志愿者（4.15±2.08 比 0.36±0.79，P<0.001；5.00±2.45 比 0.36±0.79，P<0.001；4.10±2.23 比 0.36±0.79，P<0.001，分别）。神经性厌食症患者的早饱强度-频率评分明显高于贪食症患者（3.85±2.23 比 1.17±1.83，P=0.015）、肥胖患者（3.85±2.23 比 0.00±0.00，P<0.001）和健康志愿者（3.85±2.23 比 0.05±0.21，P<0.001）。神经性贪食症和未特定的 ED 患者出现恶心和上腹压迫感。具体来说，与神经性厌食症患者相比，贪食症和未特定的 ED 患者的恶心强度-频率评分明显更高（3.17±2.56 比 0.89±1.66，P=0.04；2.70±2.91 比 0.89±1.66，P=0.05，分别），体质瘦弱者（3.17±2.56 比 0.00±0.00，P=0.004；2.70±2.91 比 0.00±0.00，P=0.005，分别），肥胖患者（3.17±2.56 比 0.00±0.00，P<0.001；3.17±2.56 比 0.00±0.00，P<0.001，分别）和健康志愿者（3.17±2.56 比 0.17±0.71，P=0.002；3.17±2.56 比 0.17±0.71，P=0.001，分别）。贪食症和未特定的 ED 患者的上腹烧灼感强度-频率评分明显高于体质瘦弱者（4.67±2.42 比 1.22±1.72，P=0.03；4.20±2.21 比 1.22±1.72，P=0.03，分别），肥胖患者（4.67±2.42 比 0.75±1.32，P=0.001；4.20±2.21 比 0.75±1.32，P<0.001，分别）和健康志愿者（4.67±2.42 比 0.67±1.46，P=0.001；4.20±2.21 比 0.67±1.46，P=0.001，分别）。100%的神经性贪食症患者、20%的未特定的 ED 患者、15%的神经性厌食症患者、22%的体质瘦弱者和 5.6%的健康志愿者出现呕吐（χ(2)，P<0.001）。