健康志愿者和功能性消化不良患者胃排空的性别差异

Gender Difference of Gastric Emptying in Healthy Volunteers and Patients with Functional Dyspepsia.

作者信息

Mori Hideki, Suzuki Hidekazu, Matsuzaki Juntaro, Taniguchi Kanami, Shimizu Toshiyuki, Yamane Tsuyoshi, Masaoka Tatsuhiro, Kanai Takanori

机构信息

Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan.

出版信息

Digestion. 2017;95(1):72-78. doi: 10.1159/000452359. Epub 2017 Jan 5.

DOI:10.1159/000452359

PMID:28052285

Abstract

BACKGROUND AND AIM

Delayed gastric emptying is one of the reasons why functional dyspepsia (FD) occurs. The 13C-acetate breath test is widely used to evaluate gastric emptying. Nevertheless, the standard value of 13C-acetate breath test has not taken into account the gender difference of gastric emptying among healthy individuals. The main aim of this study was to readjust the standard value of 13C-acetate breath test in the light of gender differences. In addition, we clarified the prevalence and clinical characteristics of delayed gastric emptying in patients with FD using the modified standard values of 13C-acetate breath test.

METHODS

Fifty-two healthy individuals and 126 patients with patients with FD were enrolled. Gastric emptying was evaluated by the 13C-acetate breath test. The cut-off points of Tmax for the diagnosis of delayed gastric emptying were determined on the basis of results from healthy individuals making a distinction of genders. Gastroesophageal reflux symptoms, dyspeptic symptoms, scores of anxiety and depression, age, body mass index (BMI), smoking and alcohol consumption were compared between the delayed gastric emptying group and the non-delayed gastric emptying group.

RESULTS

Since gastric emptying was delayed in healthy women compared with that in healthy men (Tmax, 53.6 ± 19.3 vs. 42.7 ± 16.9 min, p = 0.04), we set the cut-off points of Tmax at 60 min in men and at 75 min in women. In patients with FD, the prevalence of delayed gastric emptying was not different between men and women with the modified standard values of 13C-acetate breath test. (31.0 vs. 27.4%, p = 0.68). BMI was lower in the delayed gastric emptying group than in the non-delayed group among the male patients. Reflux symptoms were more severe in delayed gastric emptying group than in the non-delayed group among the female patients.

CONCLUSION

The standard values of 13C-acetate breath test should be modified bearing the gender difference in mind. It provides us more appropriate information to understand the mechanisms of FD.

摘要

背景与目的

胃排空延迟是功能性消化不良（FD）发生的原因之一。13C-醋酸呼气试验被广泛用于评估胃排空。然而，13C-醋酸呼气试验的标准值尚未考虑健康个体胃排空的性别差异。本研究的主要目的是根据性别差异重新调整13C-醋酸呼气试验的标准值。此外，我们使用调整后的13C-醋酸呼气试验标准值阐明了FD患者胃排空延迟的患病率及临床特征。

方法

纳入52名健康个体和126例FD患者。通过13C-醋酸呼气试验评估胃排空。根据健康个体的结果并区分性别确定诊断胃排空延迟的Tmax截止点。比较胃排空延迟组和非胃排空延迟组之间的胃食管反流症状、消化不良症状、焦虑和抑郁评分、年龄、体重指数（BMI）、吸烟和饮酒情况。

结果

由于健康女性的胃排空比健康男性延迟（Tmax，53.6±19.3 vs. 42.7±16.9分钟，p = 0.04），我们将男性的Tmax截止点设定为60分钟，女性为75分钟。在FD患者中，使用调整后的13C-醋酸呼气试验标准值，胃排空延迟的患病率在男性和女性之间没有差异（31.0%对27.4%，p = 0.68）。男性患者中，胃排空延迟组的BMI低于非延迟组。女性患者中，胃排空延迟组的反流症状比非延迟组更严重。