Gastroenterology Section, Temple University School of Medicine, Philadelphia, Pennsylvania.
Gastroenterology Section, Temple University School of Medicine, Philadelphia, Pennsylvania.
Clin Gastroenterol Hepatol. 2019 Jul;17(8):1489-1499.e8. doi: 10.1016/j.cgh.2018.10.050. Epub 2018 Nov 4.
BACKGROUND & AIMS: Gastroparesis is a chronic disorder of the stomach characterized by nausea, vomiting, early satiety, postprandial fullness, and abdominal pain. There is limited information on gastroparesis in minority populations. We assessed ethnic, racial, and sex variations in the etiology, symptoms, quality of life, gastric emptying, treatments, and symptom outcomes of patients with gastroparesis.
We collected information from the National Institutes of Health Gastroparesis Consortium on 718 adult patients, from September 2007 through December 2017. Patients were followed every 4 or 6 months, when data were collected on medical histories, symptoms (based on answers to the PAGI-SYM questionnaires), and quality of life (based on SF-36). Follow-up information collected at 1 year (48 week) was used in this analysis. Comparisons were made between patients of self-reported non-Hispanic white, non-Hispanic black, and Hispanic ethnicities, as well as and between male and female patients.
Our final analysis included 552 non-Hispanic whites (77%), 83 persons of Hispanic ethnicity (12%), 62 non-Hispanic blacks (9%), 603 women (84%), and 115 men (16%). A significantly higher proportion of non-Hispanic blacks (60%) had gastroparesis of diabetic etiology than of non-Hispanic whites (28%); non-Hispanic blacks also had more severe retching (2.5 vs 1.7 score) and vomiting (2.9 vs 1.8 score) and a higher percentage were hospitalized in the past year (66% vs 38%). A significantly higher proportion of Hispanics had gastroparesis of diabetic etiology (59%) than non-Hispanic whites (28%), but Hispanics had less-severe nausea (2.7 vs 3.3 score), less early satiety (3.0 vs 3.5 score), and a lower proportion used domperidone (8% vs 21%) or had a peripherally inserted central catheter (1% vs 7%). A higher proportion of women had gastroparesis of idiopathic etiology (69%) than men (46%); women had more severe symptoms of stomach fullness (3.6 vs 3.1 score), early satiety (3.5 vs 2.9 score), postprandial fullness (3.7 vs 3.1 score), bloating (3.3 vs 2.6 score), stomach visibly larger (3.0 vs 2.1 score), and upper abdominal pain (2.9 vs 2.4 score). A lower proportion of women were hospitalized in past year (39% vs 53% of men).
In patients with gastroparesis, etiologies, symptom severity, and treatments vary among races and ethnicities and between sexes. ClinicalTrials.gov Identifier: NCT01696747.
胃轻瘫是一种以恶心、呕吐、早饱、餐后饱胀和腹痛为特征的慢性胃部疾病。少数人群中胃轻瘫的信息有限。我们评估了胃轻瘫患者在病因、症状、生活质量、胃排空、治疗和症状结果方面的种族、民族和性别的差异。
我们从 2007 年 9 月至 2017 年 12 月,通过美国国立卫生研究院胃轻瘫联合会,收集了 718 名成年患者的信息。当收集到患者的医疗史、症状(基于 PAGI-SYM 问卷的答案)和生活质量(基于 SF-36)数据时,每 4 或 6 个月对患者进行一次随访。本分析使用了 1 年(48 周)时的随访信息。我们比较了自报为非西班牙裔白人、非西班牙裔黑人、西班牙裔的患者,以及男性和女性患者之间的差异。
我们的最终分析包括 552 名非西班牙裔白人(77%)、83 名西班牙裔(12%)、62 名非西班牙裔黑人(9%)、603 名女性(84%)和 115 名男性(16%)。非西班牙裔黑人(60%)胃轻瘫的糖尿病病因比例明显高于非西班牙裔白人(28%);非西班牙裔黑人也有更严重的干呕(2.5 分与 1.7 分)和呕吐(2.9 分与 1.8 分),且过去一年住院的比例更高(66%与 38%)。西班牙裔患糖尿病引起的胃轻瘫的比例明显高于非西班牙裔白人(59%与 28%),但西班牙裔的恶心症状(2.7 分与 3.3 分)更轻,早饱(3.0 分与 3.5 分)更轻,使用多潘立酮(8%与 21%)或外周插入中心导管(1%与 7%)的比例更低。女性中特发性胃轻瘫的比例明显高于男性(69%与 46%);女性胃饱满(3.6 分与 3.1 分)、早饱(3.5 分与 2.9 分)、餐后饱胀(3.7 分与 3.1 分)、腹胀(3.3 分与 2.6 分)、上腹可视增大(3.0 分与 2.1 分)和上腹痛(2.9 分与 2.4 分)的症状更严重。过去一年住院的女性比例较低(39%与 53%的男性)。
在胃轻瘫患者中,病因、症状严重程度和治疗方法在种族和民族之间以及在性别之间存在差异。临床试验.gov 标识符:NCT01696747。