Department of Internal Medicine, Seoul National University Bundang Hospital, Seoungnam, Gyeonggi-do 13620, South Korea.
Department of Gastroenterology, Wonkwang Digestive Disease Research Institute, Wonkwang University Sanbon Hospital, Gunpo, Gyeonggi-do 1142, South Korea.
World J Gastroenterol. 2017 Dec 7;23(45):8053-8061. doi: 10.3748/wjg.v23.i45.8053.
to evaluate gender differences in the aspect of ghrelin, nociception-related genes and psychological aspects and the quality of life (QoL) in Korean functional dyspepsia (FD) patients.
Total of 191 persons were prospectively enrolled between March 2013 and May 2016 in Seoul National Bundang Hospital, and classified into control and FD group based on ROME III criteria. Questionnaire included assessment for dyspepsia symptoms, QoL and anxiety or depression. Preproghrelin and nociception genes in the gastric mucosa and plasma acyl/des-acyl ghrelin were measured.
Lower level of plasma acyl ghrelin in FD patients compared to control was significant only in male (15.9 fmol/mL 10.4 fmol/mL, = 0.017). Significantly higher mRNA expressions of nerve growth factor and transient receptor potential vanilloid receptor 1 were observed in male ( = 0.002 and = 0.014, respectively) than in female. In contrast, female FD patients had a higher anxiety and depression score than male FD ( = 0.029), and anxiety score was correlated with epigastric pain only in female FD patients (female: Spearman rho = 0.420, = 0.037). The impairment of overall QoL was more prominent in female FD patients than male patients (5.4 ± 0.3 6.5 ± 0.3, = 0.020).
Gender differences of ghrelin and nociception-related genes in male and psychological factors in female underlie FD symptoms. More careful assessment of psychological or emotional status is required particularly for the female FD patients.
评估韩国功能性消化不良（FD）患者的胃饥饿素、痛觉相关基因和心理方面的性别差异，以及生活质量（QoL）。
2013 年 3 月至 2016 年 5 月期间，前瞻性地在首尔国立盆唐医院招募了 191 名受试者，并根据罗马 III 标准将其分为对照组和 FD 组。问卷包括消化不良症状、QoL 和焦虑或抑郁评估。测量胃黏膜和血浆酰基/去酰基胃饥饿素前胃饥饿素和痛觉相关基因。
与对照组相比，FD 患者的血浆酰基胃饥饿素水平较低，仅在男性中具有统计学意义（15.9 fmol/mL 10.4 fmol/mL， = 0.017）。与女性相比，男性 FD 患者的神经生长因子和瞬时受体电位香草酸受体 1 的 mRNA 表达显著升高（分别为 = 0.002 和 = 0.014）。相反，女性 FD 患者的焦虑和抑郁评分高于男性 FD（ = 0.029），并且只有女性 FD 患者的上腹痛与焦虑评分相关（女性：Spearman rho = 0.420， = 0.037）。与男性患者相比，女性 FD 患者的整体 QoL 受损更为明显（5.4 ± 0.3 6.5 ± 0.3， = 0.020）。
FD 症状的性别差异与男性胃饥饿素和痛觉相关基因以及女性心理因素有关。对于女性 FD 患者，需要特别注意评估心理或情绪状态。
