Department of Neurology, Seoul National University College of Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, 20 Boramae-Ro 5-Gil, Dongjak-Gu, Seoul, 07061, South Korea.
Division of Gastroenterology, Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea.
Neurol Sci. 2023 Jul;44(7):2375-2384. doi: 10.1007/s10072-023-06710-2. Epub 2023 Mar 1.
Sex differences in gastrointestinal dysfunction have not been systematically analyzed in patients with Parkinson's disease (PD). This study was aimed to investigate the sex differences in gastrointestinal dysfunctions among the patients with PD using a multicenter trial dataset.
We analyzed the baseline data of prospectively enrolled set of patients with gastrointestinal dysfunctions. Possible sex differences in gastrointestinal symptoms assessed on the Nepean Dyspepsia Index-Korean Version (NDI-K), gastrointestinal symptom diary, and Bristol stool scale were analyzed in association with clinical PD severity and antiparkinsonian drug dosages by multiple linear regression models. We also performed post hoc analysis of the dyspepsia symptom sub-items, adjusting for multiple comparisons.
Sixty-six of the 144 participants were female (45.8%). There were no differences in age, PD duration, Hoehn and Yahr stage, and daily dopaminergic medication dosages between sexes. NDI-K symptom and dyspepsia scores were correlated with the activity of daily living in females but not in males. In the multiple regression analysis controlling for all possible variables, female patients were shown to have worse gastrointestinal symptoms than males. When we performed post hoc analysis of the dyspepsia symptoms, inability to finish a regular meal and nausea were significantly worse in female patients. Gastrointestinal symptom diary supported that female patients more frequently complained of early fullness and bloating in the upper abdomen after meals than males, and burning pain in upper abdomen was more severe in female patients.
Gastrointestinal dysfunctions may differentially affect female and male PD patients.
胃肠道功能障碍在帕金森病(PD)患者中尚未进行系统的性别差异分析。本研究旨在使用多中心试验数据集探讨 PD 患者胃肠道功能障碍的性别差异。
我们分析了胃肠道功能障碍患者前瞻性入组的基线数据。通过多线性回归模型,分析了用韩国版 Nepean 消化不良指数(NDI-K)、胃肠道症状日记和布里斯托粪便量表评估的胃肠道症状与临床 PD 严重程度和抗帕金森病药物剂量之间可能存在的性别差异。我们还对消化不良症状的亚项进行了事后分析,以调整多重比较。
144 名参与者中有 66 名(45.8%)为女性。男女之间在年龄、PD 病程、Hoehn 和 Yahr 分期以及每日多巴胺能药物剂量方面无差异。NDI-K 症状和消化不良评分与女性的日常生活活动相关,而与男性无关。在控制所有可能变量的多回归分析中,女性患者的胃肠道症状比男性患者更差。当我们对消化不良症状进行事后分析时,女性患者无法完成正常餐食和恶心的症状明显比男性患者更差。胃肠道症状日记支持女性患者在餐后更频繁地报告早饱和上腹部饱胀,以及上腹部烧灼感比男性患者更严重。
胃肠道功能障碍可能会对女性和男性 PD 患者产生不同的影响。