Copyright
©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
Gender differences in ghrelin, nociception genes, psychological factors and quality of life in functional dyspepsia
Yoon Jin Choi, Young Soo Park, Nayoung Kim, Yong Sung Kim, Sun Min Lee, Dong Ho Lee, Hyun Chae Jung
Yoon Jin Choi, Young Soo Park, Nayoung Kim, Sun Min Lee, Dong Ho Lee, Department of Internal Medicine, Seoul National University Bundang Hospital, Seoungnam, Gyeonggi-do 13620, South Korea
Nayoung Kim, Dong Ho Lee, Hyun Chae Jung, Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, 03080, South Korea
Yong Sung Kim, Department of Gastroenterology, Wonkwang Digestive Disease Research Institute, Wonkwang University Sanbon Hospital, Gunpo, Gyeonggi-do 1142, South Korea
Author contributions: Choi YJ and Park YS equally contributed to this manuscript; Choi YJ and Park YS analyzed data and drafted the article; Kim N designed this study, collected the data and supervised the writing of the this manuscript; Kim YS and Lee SM edited the manuscript; Lee DH and Jung HC provided advice on the study design and supervised the writing of the manuscript; all authors have read and approved the final draft of this paper.
Supported by Support Program for Women in Science, Engineering and Technology through the National Research Foundation of Korea funded by the Ministry of Science, ICT and Future Planning, no. 2016H1C3A1903202.
Institutional review board statement: The Institutional Review Board of SNUBH approved this study (B-1101/119-010).
Informed consent statement: Written informed consent was obtained from all participants.
Conflict-of-interest statement: All authors declare that they have no conflict of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Nayoung Kim, MD, Department of Internal Medicine, Seoul National University Bundang Hospital, 82, Gumi-ro 173beon-gil, Bundang-gu, Seongnam, Gyeonggi-do 13620, South Korea. nayoungkim49@empas.com
Telephone: +82-31-7877008 Fax: +82-31-7874051
Received: August 3, 2017
Peer-review started: August 5, 2017
First decision: September 13, 2017
Revised: September 27, 2017
Accepted: November 8, 2017
Article in press: November 8, 2017
Published online: December 7, 2017
ARTICLE HIGHLIGHTS
Research background
Although gender is assumed to be an important factor in the pathogenesis, progression and prognosis of certain diseases, there have been only a few reported gender differences in functional gastrointestinal disorders, and attention has focused mostly on irritable bowel syndrome.
Research motivation
Most functional gastrointestinal disorders, including functional dyspepsia, show female predominance.
Research objectives
We compared the possible etiological factors including ghrelin, nociception-related genes, psychological aspects and history of abdominal operation as well as basal characteristics, dyspepsia symptoms and quality of life between male and female functional dyspepsia patients.
Research methods
Total of 191 persons [87 subjects (male 38, female 49) and 104 patients (male 39, female 65)] were prospectively enrolled between March 2013 and May 2016 in Seoul National Bundang Hospital. They were classified into control and FD group (PDS, EPS and mixed subgroups) on the basis of ROME III criteria. Questionnaire included assessment for dyspepsia symptoms, quality of life by WHOQOL-BREF scores and anxiety or depression by HADS scores were analyzed. Preproghrelin and nociception genes were analyzed by RT-PCR from the gastric mucosa. Plasma acyl/des-acyl ghrelin were measured by ELISA method.
Research results
Differences in plasma acyl ghrelin and the gastric expressions of most nociception-related gene between dyspepsia and control groups were significant only in men. In contrast, female functional dyspepsia patients had a more anxious and depressive mood, and showed a more apparent impaired quality of life compared to male dyspeptic patients. Epigastric burning or pain was correlated with anxiety score only in women. Women who underwent any gynecologic surgery showed more severe overall abdominal symptoms than women who did not.
Research conclusions
Different mechanisms might underlie the perception of dyspeptic symptom by gender and the negative impact of the functional dyspepsia on the quality of life can be more prominent in women than men.
Research perspectives
More careful assessment of psychological or emotional status is required particularly for the female FD patients.
