Futagami Seiji, Shimpuku Mayumi, Kawagoe Tetsuro, Izumi Nikki, Ohishi Noriko, Yamawaki Hiroshi, Shindo Tomotaka, Nagoya Hiroyuki, Horie Akane, Kodaka Yasuhiro, Gudis Katya, Itoh Takashi, Sakamoto Choitsu
Department of Internal Medicine, Division of Gastroenterology, Nippon Medical School, Japan.
Intern Med. 2013;52(11):1155-63. doi: 10.2169/internalmedicine.52.8662.
An impairment of gastric motility is strongly associated with the pathophysiology of functional dyspepsia (FD). Plasma ghrelin is one of the key molecules linked to gastric motility. Therefore, this study aimed to evaluate whether ghrelin (GHRL) gene polymorphisms are associated with clinical symptoms, the plasma ghrelin levels and gastric emptying in patients with FD as defined by the Rome III classification.
We enrolled 74 Helicobacter pylori-negative patients presenting with typical symptoms of FD (epigastric pain syndrome (EPS), n=23; postprandial distress syndrome (PDS), n=51) and 102 healthy volunteers. Gastric motility was evaluated according to the Tmax value and T1/2 using the (13)C-acetate breath test. We used the Rome III criteria to evaluate upper abdominal symptoms and SRQ-D scores to determine the depression status. The Arg51Gln(346G->A), preproghrelin3056T->C, Leu72Met(408C->A) and Gln90Leu(3412T->A) polymorphisms were analyzed in DNA in blood samples obtained from the enrolled subjects. Genotyping was performed using polymerase chain reaction.
There was a significant relationship (p=0.048) between the preproghrelin 3056TT genotype and the serum levels of acylated ghrelin in the H. pylori-negative FD patients. The preproghrelin 3056TT genotype was significantly (p=0.047) associated with the feeling of hunger in the H. pylori-negative FD patients.
The preproghrelin 3056TT genotype is significantly associated with the acylated ghrelin levels and the feeling of hunger in H. pylori-negative FD patients. Further studies are needed to clarify the association between the preproghrelin 3056TT genotype and lower plasma acylated ghrelin levels and the impact of this relationship on the feeling of hunger in H. pylori-negative FD patients.
胃动力障碍与功能性消化不良（FD）的病理生理学密切相关。血浆胃饥饿素是与胃动力相关的关键分子之一。因此，本研究旨在评估胃饥饿素（GHRL）基因多态性是否与罗马III分类定义的FD患者的临床症状、血浆胃饥饿素水平及胃排空有关。
我们纳入了74例幽门螺杆菌阴性且有FD典型症状的患者（上腹部疼痛综合征（EPS），23例；餐后不适综合征（PDS），51例）以及102名健康志愿者。使用（13）C-醋酸呼气试验根据Tmax值和T1/2评估胃动力。我们采用罗马III标准评估上腹部症状，并使用SRQ-D评分确定抑郁状态。对纳入受试者血样中的DNA分析了Arg51Gln（346G->A）、前胃饥饿素3056T->C、Leu72Met（408C->A）和Gln90Leu（3412T->A）多态性。采用聚合酶链反应进行基因分型。
在幽门螺杆菌阴性的FD患者中，前胃饥饿素3056TT基因型与酰化胃饥饿素的血清水平之间存在显著关系（p=0.048）。前胃饥饿素3056TT基因型与幽门螺杆菌阴性的FD患者的饥饿感显著相关（p=0.047）。
前胃饥饿素3056TT基因型与幽门螺杆菌阴性的FD患者的酰化胃饥饿素水平及饥饿感显著相关。需要进一步研究以阐明前胃饥饿素3056TT基因型与较低血浆酰化胃饥饿素水平之间的关联，以及这种关系对幽门螺杆菌阴性的FD患者饥饿感的影响。
