Kim Su Hwan, Kim Ji Won, Byun Junsu, Jeong Ji Bong, Kim Byeong Gwan, Lee Kook Lae
Department of Internal Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Republic of Korea.
PLoS One. 2017 Apr 18;12(4):e0175231. doi: 10.1371/journal.pone.0175231. eCollection 2017.
Whether plasma ghrelin/obestatin levels are associated with Helicobacter pylori (H. pylori) infection, subtypes of functional dyspepsia (FD), and gastric mucosal histology has not yet been established in elderly patients.
The aim of this study was to determine whether plasma ghrelin and obestatin levels are related to gastric mucosal histology, H. pylori infection, and FD subtypes in elderly patients with FD.
Ninety-two patients diagnosed with FD and older than 60 years (median age 69.4; range 60-88) were included. Clinical symptoms investigated included postprandial fullness, epigastric pain, epigastric soreness, nausea, and vomiting. According to the Rome III criteria, patients diagnosed with FD were divided into two subtypes: epigastric pain syndrome (EPS) and postprandial distress syndrome (PDS). Plasma ghrelin and obestatin levels were measured using enzyme immunoassay, and histological examination of gastric mucosa was performed. H. pylori infection was determined by histopathological examination of gastric mucosal biopsy and/or Campylobacter-like organism test.
In our study, plasma ghrelin levels and plasma ghrelin/obestatin (G/O) ratio were significantly lower in subjects with intestinal metaplasia compared with those without intestinal metaplasia (ghrelin, p = 0.010; G/O ratio, p = 0.012). On the other hand, there were no significant differences in plasma ghrelin and obestatin levels between H. pylori-positive and H. pylori-negative groups. (ghrelin, p = 0.130; obestatin, p = 0.888). Similarly, no significant differences were detected between the EPS and PDS groups (ghrelin, p = 0.238; obestatin, p = 0.710).
Patients with intestinal metaplasia, a known precursor of gastric cancer, had significantly less plasma ghrelin levels and G/O ratio than those without intestinal metaplasia.
老年患者血浆胃饥饿素/肥胖抑制素水平是否与幽门螺杆菌（H. pylori）感染、功能性消化不良（FD）亚型及胃黏膜组织学相关尚未明确。
本研究旨在确定老年FD患者血浆胃饥饿素和肥胖抑制素水平是否与胃黏膜组织学、H. pylori感染及FD亚型相关。
纳入92例年龄大于60岁（中位年龄69.4岁；范围60 - 88岁）的FD诊断患者。调查的临床症状包括餐后饱胀、上腹痛、上腹部酸痛、恶心和呕吐。根据罗马III标准，将诊断为FD的患者分为两个亚型：上腹痛综合征（EPS）和餐后不适综合征（PDS）。采用酶免疫法测定血浆胃饥饿素和肥胖抑制素水平，并进行胃黏膜组织学检查。通过胃黏膜活检的组织病理学检查和/或类弯曲杆菌试验确定H. pylori感染情况。
在我们的研究中，与无肠化生的受试者相比，肠化生受试者的血浆胃饥饿素水平及血浆胃饥饿素/肥胖抑制素（G/O）比值显著降低（胃饥饿素，p = 0.010；G/O比值，p = 0.012）。另一方面，H. pylori阳性组和H. pylori阴性组之间的血浆胃饥饿素和肥胖抑制素水平无显著差异（胃饥饿素，p = 0.130；肥胖抑制素，p = 0.888）。同样，EPS组和PDS组之间未检测到显著差异（胃饥饿素，p = 0.238；肥胖抑制素，p = 0.710）。
肠化生是已知的胃癌前体，与无肠化生的患者相比伴有肠化生患者的血浆胃饥饿素水平及G/O比值显著降低。
