Eslick Guy D, Howell Stuart C, Talley Nicholas J
School of Public Health, The University of Sydney, Sydney, New South Wales, Australia.
Department of Medicine, The University of Sydney, Nepean Hospital, Penrith, New South Wales, Australia.
J Neurogastroenterol Motil. 2015 Oct 1;21(4):603-11. doi: 10.5056/jnm14124.
BACKGROUND/AIMS: Weight loss is a recognized alarm symptom for organic gastrointestinal (GI) disease, yet the association between weight change (loss or gain) and specific GI symptoms remains poorly described. We assess the associations between GI symptoms and weight change in a population-based sample of Australian adults.
The prevalence of 26 GI symptoms was determined by a postal survey to 5000 residents in western Sydney, Australia (60% response rate). These were classified a priori into 5 symptom groups-abdominal pain, esophageal symptoms, dysmotility symptoms, diarrhea and constipation. Weight change was measured by two items which assessed weight loss and weight gain. Clinically relevant weight change was defined as a loss or gain of 3 or more kilograms in the past 3 months.
Prevalence estimates for clinically relevant weight loss and gain in the past 3 months were 10.3% and 8.1%, respectively. When the 5 symptom groups were evaluated simultaneously, the dysmotility symptoms of fullness after meals emerged as a predictor of both weight loss (OR, 1.57; 95% CI, 1.32-1.88; P < 0.001) and weight gain (OR, 0.85; 95% CI, 0.72-0.99; P = 0.040), which also included bloating (OR, 1.64; 95% CI 1.46-1.84; P < 0.001). The associations remained significant following adjustment for socio-economic status, body mass index, and eating behaviors.
Specific dysmotility symptoms are independently predictive of both weight loss and weight gain. Different pathogenic mechanisms may be involved.
背景/目的：体重减轻是器质性胃肠（GI）疾病公认的警示症状，但体重变化（减轻或增加）与特定GI症状之间的关联仍鲜有描述。我们在澳大利亚成年人的基于人群的样本中评估GI症状与体重变化之间的关联。
通过对澳大利亚悉尼西部5000名居民进行邮寄调查来确定26种GI症状的患病率（回复率为60%）。这些症状被预先分类为5个症状组——腹痛、食管症状、动力障碍症状、腹泻和便秘。通过两项评估体重减轻和体重增加的项目来测量体重变化。临床相关的体重变化定义为过去3个月内体重减轻或增加3千克及以上。
过去3个月临床相关体重减轻和增加的患病率估计分别为10.3%和8.1%。当同时评估这5个症状组时，餐后饱胀的动力障碍症状成为体重减轻（比值比[OR]，1.57；95%置信区间[CI]，1.32 - 1.88；P < 0.001）和体重增加（OR，0.85；95% CI，0.72 - 0.99；P = 0.040）的预测因素，其中还包括腹胀（OR，1.64；95% CI 1.46 - 1.84；P < 0.001）。在对社会经济状况、体重指数和饮食行为进行调整后，这些关联仍然显著。
特定的动力障碍症状可独立预测体重减轻和体重增加。可能涉及不同的致病机制。
