Published online Dec 7, 2017. doi: 10.3748/wjg.v23.i45.8053
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
Processing time: 122 Days and 21.2 Hours
to evaluate gender differences in the aspect of ghrelin, nociception-related genes and psychological aspects and the quality of life (QoL) in Korean functional dyspepsia (FD) patients.
Total of 191 persons were prospectively enrolled between March 2013 and May 2016 in Seoul National Bundang Hospital, and classified into control and FD group based on ROME III criteria. Questionnaire included assessment for dyspepsia symptoms, QoL and anxiety or depression. Preproghrelin and nociception genes in the gastric mucosa and plasma acyl/des-acyl ghrelin were measured.
Lower level of plasma acyl ghrelin in FD patients compared to control was significant only in male (15.9 fmol/mL vs 10.4 fmol/mL, P = 0.017). Significantly higher mRNA expressions of nerve growth factor and transient receptor potential vanilloid receptor 1 were observed in male (P = 0.002 and P = 0.014, respectively) than in female. In contrast, female FD patients had a higher anxiety and depression score than male FD (P = 0.029), and anxiety score was correlated with epigastric pain only in female FD patients (female: Spearman rho = 0.420, P = 0.037). The impairment of overall QoL was more prominent in female FD patients than male patients (5.4 ± 0.3 vs 6.5 ± 0.3, P = 0.020).
Gender differences of ghrelin and nociception-related genes in male and psychological factors in female underlie FD symptoms. More careful assessment of psychological or emotional status is required particularly for the female FD patients.
Core tip: Gender-specific medicine has become a recently rising medical field in which differences between males and females are recognized and actively utilized in the clinical study, diagnosis and treatment. The lower level of plasma acyl ghrelin and higher expressions of nociception-related genes are associated with pathogenesis of functional dyspepsia (FD) in males, while female FD patients had more serious anxious and depressive mood. Underlying mechanism in FD could be different according to gender, and meticulous attention for psychological predisposition is required particularly in the treatment of female FD patients.