Department of Surgery, Oncology and Gastroenterology (DISCOG), Gastroenterology Unit, University of Padova-Azienda Ospedaliera di Padova, Padova, Italy.
Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
Aliment Pharmacol Ther. 2020 Sep;52(5):762-773. doi: 10.1111/apt.16006. Epub 2020 Jul 28.
BACKGROUND: Prevalence of uninvestigated dyspepsia varies across cross-sectional surveys. This may be due to differences in definitions used or study methodology, rather than global variability. AIM: To determine the global prevalence of uninvestigated dyspepsia according to Rome criteria. METHODS: MEDLINE and EMBASE were searched to identify population-based studies reporting prevalence of uninvestigated dyspepsia in adults (≥18 years old) according to Rome I, II, III or IV criteria. Prevalence of uninvestigated dyspepsia was extracted, according to criteria used to define it. Pooled prevalence, according to study location and certain other characteristics, odds ratios (OR), and 95% confidence intervals (CIs) were calculated. RESULTS: Of 2133 citations evaluated, 67 studies fulfilled eligibility criteria, representing 98 separate populations, comprising 338 383 subjects. Pooled prevalence ranged from 17.6% (95% CI 9.8%-27.1%) in studies defining uninvestigated dyspepsia according to Rome I criteria, to 6.9% (95% CI 5.7%-8.2%) in those using Rome IV criteria. Postprandial distress syndrome was the commonest subtype, occurring in 46.2% of participants using Rome III criteria, and 62.8% with Rome IV. Prevalence of uninvestigated dyspepsia was up to 1.5-fold higher in women, irrespective of the definition used. There was significant heterogeneity between studies in all our analyses, which persisted even when the same criteria were applied and similar methodology was used. CONCLUSIONS: Even when uniform symptom-based criteria are used to define the presence of uninvestigated dyspepsia, prevalence varies between countries. This suggests that there are environmental, cultural, ethnic, dietary or genetic influences determining symptoms.
背景：未调查消化不良的患病率在横断面调查中存在差异。这可能是由于使用的定义或研究方法不同，而不是全球变异性。
目的：根据罗马标准确定全球未调查消化不良的患病率。
方法：检索 MEDLINE 和 EMBASE，以确定根据罗马 I、II、III 或 IV 标准报告成年人（≥18 岁）未调查消化不良患病率的基于人群的研究。根据定义未调查消化不良的标准提取未调查消化不良的患病率。根据研究地点和其他某些特征计算了汇总患病率、比值比（OR）和 95%置信区间（CI）。
结果：在评估的 2133 条引文中有 67 项研究符合入选标准，代表了 98 个独立人群，包括 338333 名受试者。根据罗马 I 标准定义未调查消化不良的研究中，汇总患病率范围为 17.6%（95%CI 9.8%-27.1%），而根据罗马 IV 标准的研究中为 6.9%（95%CI 5.7%-8.2%）。餐后不适综合征是最常见的亚型，使用罗马 III 标准的参与者中有 46.2%，使用罗马 IV 标准的参与者中有 62.8%。无论使用何种定义，女性未调查消化不良的患病率均高达 1.5 倍。在我们所有的分析中，研究之间存在显著的异质性，即使使用相同的标准和类似的方法，这种异质性仍然存在。
结论：即使使用统一的基于症状的标准来定义未调查消化不良的存在，不同国家的患病率也存在差异。这表明存在环境、文化、种族、饮食或遗传因素决定症状。
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