Kinoshita Yoshikazu, Dibonaventura Marco, Rossi Bruno, Iwamoto Kazuya, Wang Edward C Y, Briere Jean-Baptiste
Department of Gastroenterology and Hepatology, Shimane University School of Medicine, Izumo, Japan.
Clin Exp Gastroenterol. 2013 May 20;6:51-9. doi: 10.2147/CEG.S39628. Print 2013.
The aim of this study was to investigate the link between atrial fibrillation (AF) and dyspepsia, as well as the contribution of dyspepsia to the overall burden of AF.
The 2008, 2009, and 2010 Japan National Health and Wellness Survey (NHWS) datasets were used in this study. The NHWS is an Internet-based survey administered to the adult population in Japan using a random stratified sampling framework to ensure demographic representativeness. The presence of dyspepsia was compared between those with and without AF. Among those with AF, the effect of dyspepsia on health status, work productivity, and activity impairment was examined, along with health care resource use using multivariable regression modeling and controlling for baseline differences.
Among patients with AF (n = 565), the three most commonly reported comorbidities were hypertension (38.76%), dyspepsia (37.35%), and overactive bladder (28.72%). Patients with AF had 48.59% greater odds of reporting dyspepsia than those without AF (P < 0.05). Patients with dyspepsia used more AF medications (2.05 versus 1.54) and had been diagnosed more recently (9.97 versus 10.58 years). Dyspepsia was associated with significantly worse physical health status (P < 0.05) and significantly more absenteeism, overall work impairment, activity impairment, physician visits, and emergency room visits (all P < 0.05).
Patients with AF in Japan experience a number of comorbidities, with dyspepsia being the most common noncardiovascular comorbidity. Given the prevalence and additional burden of this comorbidity across both humanistic and economic outcomes, the management of dyspepsia among patients with AF should be an area of greater focus.
本研究旨在调查心房颤动（AF）与消化不良之间的联系，以及消化不良对AF总体负担的影响。
本研究使用了2008年、2009年和2010年日本国民健康与福祉调查（NHWS）数据集。NHWS是一项基于互联网的调查，采用随机分层抽样框架对日本成年人口进行调查，以确保人口统计学代表性。比较了有AF和无AF者的消化不良情况。在AF患者中，采用多变量回归模型并控制基线差异，研究了消化不良对健康状况、工作效率和活动障碍的影响，以及医疗资源的使用情况。
在AF患者（n = 565）中，最常报告的三种合并症是高血压（38.76%）、消化不良（37.35%）和膀胱过度活动症（28.72%）。AF患者报告消化不良的几率比无AF者高48.59%（P < 0.05）。消化不良患者使用的AF药物更多（2.05对1.54），且确诊时间更近（9.97对10.58年）。消化不良与显著更差的身体健康状况相关（P < 0.05），且旷工、总体工作障碍、活动障碍、看医生和急诊就诊次数显著更多（均P < 0.05）。
日本的AF患者存在多种合并症，消化不良是最常见的非心血管合并症。鉴于这种合并症在人文和经济结果方面的患病率及额外负担，AF患者消化不良的管理应成为更受关注的领域。
