Zádori Noémi, Németh Dávid, Frim Levente, Vörhendi Nóra, Szakó Lajos, Váncsa Szilárd, Hegyi Péter, Czimmer József
Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary.
János Szentágothai Research Centre, University of Pécs, Pécs, Hungary.
Int J Gen Med. 2022 Oct 12;15:7789-7796. doi: 10.2147/IJGM.S380419. eCollection 2022.
Dyspeptic symptoms are frequent in the general population, with a high socioeconomic burden. () might be a possible etiological factor; however, it is also common in negative gastritis. Clarification of the underlying aetiology might be beneficial to set up the optimal treatment strategy for dyspepsia and chronic gastritis (CG) itself. We aimed to assess the prevalence of dyspeptic symptoms in patients with negative CG and explore autoimmunity's possible role.
This retrospective study included data from patients with negative CG. Exclusion criteria were (1) acute gastritis; (2) reactive gastropathy; (3) subjects without any serology testing results; (4) positivity; (5) presence of atrophy, intestinal metaplasia (IM), gastroesophageal reflux disease (GERD), ulcer, or cancer. The following endpoints were assessed (1) the rate of dyspepsia-like symptoms; (2) association between dyspepsia and autoimmune disease-related seromarker positivity (AISP); (3) frequency of other symptoms in CG and its association with AISP; (4) location of the inflammation and its association with AISP.
From a total of 285 patients, 175 were included in this study. Among these patients, 95 experienced dyspeptic symptoms (54.29%) and were associated more with AISP (p = 0.012), especially with celiac seropositivity (p = 0.045), anti-neutrophil cytoplasmic antibody (ANCA) and anti-Saccharomyces cerevisiae antibodies (ASCA) positivity (p = 0.043). A significant association was not found with other tested autoimmune (AI)-related antibody positivity.
Positivity of seromarkers of autoimmune diseases in chronic gastritis may predispose to have dyspeptic symptoms and may be the causative factor behind some cases of uninvestigated dyspepsia. These data suggest that further prospective studies are needed to clarify whether screening for autoantibodies in patients with dyspepsia is cost-effective and helps the earlier diagnosis of autoimmune diseases.
消化不良症状在普通人群中很常见，具有较高的社会经济负担。（）可能是一个潜在的病因；然而，它在阴性胃炎中也很常见。明确潜在病因可能有助于为消化不良和慢性胃炎（CG）制定最佳治疗策略。我们旨在评估阴性CG患者中消化不良症状的患病率，并探讨自身免疫可能发挥的作用。
这项回顾性研究纳入了阴性CG患者的数据。排除标准为：（1）急性胃炎；（2）反应性胃病；（3）无任何血清学检测结果的受试者；（4）（检测结果）阳性；（5）存在萎缩、肠化生（IM）、胃食管反流病（GERD）、溃疡或癌症。评估了以下终点：（1）消化不良样症状的发生率；（2）消化不良与自身免疫性疾病相关血清标志物阳性（AISP）之间的关联；（3）CG中其他症状的频率及其与AISP的关联；（4）炎症部位及其与AISP的关联。
在总共285例患者中，175例纳入本研究。在这些患者中，95例有消化不良症状（54.29%），且与AISP的关联更为密切（p = 0.012），尤其是与乳糜泻血清阳性（p = 0.045）、抗中性粒细胞胞浆抗体（ANCA）和抗酿酒酵母抗体（ASCA）阳性（p = 0.043）。未发现与其他检测的自身免疫（AI）相关抗体阳性有显著关联。
慢性胃炎中自身免疫性疾病血清标志物阳性可能易导致消化不良症状，可能是一些不明原因消化不良病例的致病因素。这些数据表明，需要进一步的前瞻性研究来阐明对消化不良患者进行自身抗体筛查是否具有成本效益，并有助于自身免疫性疾病的早期诊断。
