Choi YJ, Park YS, Kim N, Kim YS, Lee SM, Lee DH, Jung HC. Gender differences in ghrelin, nociception genes, psychological factors and quality of life in functional dyspepsia. World J Gastroenterol 2017; 23(45): 8053-8061 [PMID: 29259381 DOI: 10.3748/wjg.v23.i45.8053]
Corresponding Author of This Article
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
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Prospective Study
Open-Access Policy of This Article
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/
World J Gastroenterol. Dec 7, 2017; 23(45): 8053-8061 Published online Dec 7, 2017. doi: 10.3748/wjg.v23.i45.8053
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 Processing time: 122 Days and 21.2 Hours
Abstract
AIM
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.
METHODS
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.
RESULTS
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).
CONCLUSION
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.
