Khalil Jacqueline, Hill Hannah, Kaelber David, Song Gengqing
Department of Internal Medicine, MetroHealth Medical Center, Case Western Reserve University, Cleveland, OH 44109, USA.
Population Health and Equity Research Institute, MetroHealth Medical Center, Case Western Reserve University, Cleveland, OH 44109, USA.
J Pers Med. 2024 Feb 29;14(3):275. doi: 10.3390/jpm14030275.
Female sex hormones have been hypothesized to influence the higher prevalence of gastroparesis in females. This study investigated the effects of hormone replacement therapy (HRT) on gastroparesis and its related symptoms, medication use, and diagnostic testing in post-menopausal women. Utilizing the TriNetX platform, we conducted a population-based cohort study involving post-menopausal women aged 50 or older, with and without HRT. One-to-one propensity score matching was performed to adjust for age, race, ethnicity, diabetes, body mass index (BMI), and hemoglobin A1c. The exclusion criteria included functional dyspepsia, cyclic vomiting syndrome, and surgical procedures. After applying the exclusion criteria, we identified 78,192 post-menopausal women prescribed HRT and 1,604,822 not prescribed HRT. Post-propensity matching, each cohort comprised 67,874 patients. A total of 210 of the post-menopausal women prescribed HRT developed an ICD encounter diagnosis of gastroparesis at least 30 days after being prescribed HRT compared to post-menopausal women not prescribed HRT (OR = 1.23, 95% CI [1.01-1.51] -value = 0.0395). These associations persisted in sensitivity analysis over 5 years (OR = 1.65, 95% CI [1.13-2.41] -value = 0.0086). HRT was associated with increased GI symptoms, including early satiety (OR = 1.22, 95% CI [1.03-1.45] -value = 0.0187), domperidone use (OR = 2.40, 95% CI [1.14-5.02] -value = 0.0163), and undergoing gastric emptying studies (OR = 1.67, 95% CI [1.39-2.01] -value < 0.0001). HRT is linked to an increased risk of developing an ICD encounter diagnosis of gastroparesis.
已有假说认为女性性激素会影响女性胃轻瘫患病率较高的情况。本研究调查了激素替代疗法（HRT）对绝经后女性胃轻瘫及其相关症状、药物使用和诊断检测的影响。利用TriNetX平台，我们进行了一项基于人群的队列研究，纳入了年龄在50岁及以上、使用或未使用HRT的绝经后女性。进行一对一倾向评分匹配以调整年龄、种族、民族、糖尿病、体重指数（BMI）和糖化血红蛋白。排除标准包括功能性消化不良、周期性呕吐综合征和外科手术。应用排除标准后，我们确定了78192名接受HRT治疗的绝经后女性和1604822名未接受HRT治疗的绝经后女性。倾向评分匹配后，每个队列包括67874名患者。与未接受HRT治疗的绝经后女性相比，共有210名接受HRT治疗的绝经后女性在接受HRT治疗至少30天后出现了胃轻瘫的国际疾病分类（ICD）会诊诊断（比值比[OR]=1.23，95%置信区间[CI][1.01-1.51]，P值=0.0395）。这些关联在5年的敏感性分析中持续存在（OR=1.65，95%CI[1.13-2.41]，P值=0.0086）。HRT与胃肠道症状增加有关，包括早饱（OR=1.22，95%CI[1.03-1.45]，P值=0.0187）、多潘立酮使用（OR=2.40，95%CI[1.14-5.02]，P值=0.0163）和接受胃排空研究（OR=1.67，95%CI[1.39-2.01]，P值<0.0001）。HRT与出现胃轻瘫的ICD会诊诊断风险增加有关。
