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肠易激综合征临床症状、生活质量及生化因素的性别差异

Sex-Related Differences in Clinical Symptoms, Quality of Life, and Biochemical Factors in Irritable Bowel Syndrome.

作者信息

Choghakhori Razieh, Abbasnezhad Amir, Amani Reza, Alipour Meysam

机构信息

Nutritional Health Research Center, Department of Nutrition, Lorestan University of Medical Sciences, Goledasht Blvd, Khorramabad, 6813833946, Iran.

Nutrition and Metabolic Diseases Researcher Center, Department of Nutrition, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.

出版信息

Dig Dis Sci. 2017 Jun;62(6):1550-1560. doi: 10.1007/s10620-017-4554-6. Epub 2017 Apr 3.

Abstract

BACKGROUND

Due to the sex differences in physiological and psychological factors, it can be speculated that clinical presentation of symptoms in male and female patients with irritable bowel syndrome (IBS) might be different.

AIM

To evaluate sex-related differences in clinical symptoms, quality of life, and biochemical factors in IBS.

METHODS

Ninety IBS patients (29 men, 61 women (45 premenopausal, 16 postmenopausal)) were recruited from the outpatient clinic of the University Hospital. All the patients met the Rome III Diagnostic Criteria. The IBS severity score system (IBS-SSS), gastrointestinal (GI) symptoms, IBS specific quality of life (IBS-QoL), and biochemical factors (IL-17, IL-10, TNFα, malondialdehyde (MDA), total antioxidant capacity (TAC)) were assessed.

RESULTS

Diarrhea predominant IBS (IBS-D) was more common in men (44.8%), whereas constipation-predominant IBS (IBS-C) and alternating bowel habits IBS (IBS-A) were more common in women (39.3, 42.6%, respectively). The women had a greater severity of abdominal distention, rumbling, flatulence, and dissatisfaction with bowel habits as compared with men. The scores of IBS-QoL in women were significantly (P < 0.05) lower than those in men. Moreover, pro-inflammatory cytokines (IL-17, TNFα) increased, and anti-inflammatory cytokine (IL-10) decreased in women versus men. In addition, there was no significant difference (P > 0.05) between pre- and postmenopausal women in the severity of symptoms. All of the GI symptoms and IBS-SSS have a significant negative correlation with IBS-QoL in both men and women.

CONCLUSIONS

Female with IBS reports a greater severity of IBS symptoms, increased inflammatory cytokines, and has an impaired quality of life compared with male.

摘要

背景

由于生理和心理因素存在性别差异,推测肠易激综合征(IBS)男性和女性患者的症状临床表现可能有所不同。

目的

评估IBS患者临床症状、生活质量和生化因素的性别差异。

方法

从大学医院门诊招募90例IBS患者(29例男性,61例女性(45例绝经前,16例绝经后))。所有患者均符合罗马III诊断标准。评估IBS严重程度评分系统(IBS-SSS)、胃肠道(GI)症状、IBS特定生活质量(IBS-QoL)和生化因素(白细胞介素-17(IL-17)、白细胞介素-10(IL-10)、肿瘤坏死因子α(TNFα)、丙二醛(MDA)、总抗氧化能力(TAC))。

结果

腹泻型IBS(IBS-D)在男性中更为常见(44.8%),而便秘型IBS(IBS-C)和混合型IBS(IBS-A)在女性中更为常见(分别为39.3%、42.6%)。与男性相比,女性腹胀、肠鸣、肠胃胀气和对排便习惯的不满程度更严重。女性的IBS-QoL评分显著低于男性(P<0.05)。此外,与男性相比,女性促炎细胞因子(IL-17、TNFα)升高,抗炎细胞因子(IL-10)降低。此外,绝经前和绝经后女性在症状严重程度上无显著差异(P>0.05)。男性和女性的所有GI症状和IBS-SSS与IBS-QoL均呈显著负相关。

结论

与男性相比,IBS女性报告的IBS症状更严重,炎症细胞因子增加,生活质量受损。

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