Gender differences in ghrelin, nociception genes, psychological factors and quality of life in functional dyspepsia

doi:10.3748/wjg.v23.i45.8053

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World Journal of Gastroenterology

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1007-9327

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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World J Gastroenterol. Dec 7, 2017; 23(45): 8053-8061
Published online Dec 7, 2017. doi: 10.3748/wjg.v23.i45.8053

Table 1 Characteristics of the subjects n (%)

Variables	Control (n = 87)			FD (n = 104)			P value
Variables	Total(n = 87)	Male(n = 38)	Female(n = 49)	Total(n = 104)	Male(n = 39)	Female(n = 65)	Control vs FD	Control¹	FD¹
Age (mean ± SD, yr)	54.9 ± 12.1	57.4 ± 12.1	52.9 ± 11.8	50.5 ± 11.3	49.6 ± 11.6	51.3 ± 11.1	0.010	0.084	0.536
Male	38 (43.7)	38 (100)	0	39 ( 37.5)	39 (100)	0	0.386	-	-
BMI (mean ± SD, kg/m²)	23.1 ± 2.9	22.4 ± 2.9	22.9 ± 3.30	22.4 ± 3.0	23.3 ± 2.7	21.9 ± 3.4	0.140	0.482	0.039
H. pylori	58 (66.7)	23 (60.5)	35 (71.4)	60 (57.7)	21 (53.8)	39 (60.0)	0.204	0.360	0.547
AG antrum	33 (37.9)	15 (39.5)	18 (36.7)	28 (26.9)	9 (23.1)	19 (29.2)	0.104	0.794	0.493
AG body	13 (14.9)	5 (13.2)	8 (16.3)	11 (10.6)	4 (10.3)	7 (10.8)	0.365	0.681	0.999
IM antrum/body	22 (25.3)	12 (31.6)	10 (20.4)	18 (17.3)	6 (15.4)	12 (18.5)	0.177	0.234	0.688
Smoking	13 (14.9)	10 (26.3)	1 (2.0)	24 (23.1)	17 (43.6)	2 (3.1)	< 0.001	< 0.001	< 0.001
Alcohol	20 (23.0)	16 (42.1)	4 (8.2)	30 (28.8)	21 (53.8)	9 (13.8)	0.342	< 0.001	< 0.001
Gynecologic surgery²	-	-	13/43 (30.2)	-	-	25/48 (52.1)	0.171	-	-
Subtype in FD	-	-	-	-	-	-	-	-	-
PDS	-	-	-	-	9 (23.1)	15 (23.1)	-	-	0.408
EPS	-	-	-	-	6 (15.4)	17 (26.2)	-	-	-
Mixed	-	-	-	-	24 (61.5)	33 (50.8)	-	-	-

¹Between males and females;

²Hysterectomy, salpingooophorectomy or cesarean section were included. Only some patients responded to this question. AG: Atrophic gastritis; BMI: Body mass index; EPS: Epigastric pain syndrome; mixed, postprandial distress syndrome and epigastric pain syndrome; FD: Functional dyspepsia; IM: Intestinal metaplasia; PDS: Postprandial distress syndrome; SD: Standard deviation; -: not available.

Table 2 Expression of plasma ghrelin, gastric peproghrelin and nociception-related genes in the control and functional dyspepsia groups

Variables	Control (n = 87)			FD (n = 104)			P value¹
	Total	Male	Female	Total	Male	Female	Control vs FD	Control²	FD²
	(n = 87)	(n = 38)	(n = 49)	(n = 104)	(n = 39)	(n = 65)	Control vs FD	Control²	FD²
Plasma acyl ghrelin (fmol/mL, median [IQR])	14.1 (9.1-20.8)	15.9 (9.2-33.7)	12.2 (9.0-18.6)	11.2 (6.6-16.8)	10.4 (6.5-18.4)	11.4 (6.8-16.5)	0.018	0.204	0.388
Plasma des-acyl ghrelin(fmol/mL, median [IQR])	67.9 (37.5-162.5)	108 (31.8-212.9)	65.4 (38.2-111.0)	62.1 (32.2-110.6)	58.5 (28.8-134.3)	63.6 (32.2-108.0)	0.297	0.389	0.913
Ghrelin mRNA (median [IQR])	2.6 (0.7-4.9)	2.1 (0.5-4.2)	3.2 (1.0-6.1)	1.7 (0.4-5.4)	1.9 (0.4-9.0)	1.5 (0.3-4.7)	0.435	0.076	0.308
NGF mRNA (median [IQR])	1.1 (0.7-1.7)	1.2 (0.7-1.8)	0.9 (0.5-1.6)	1.6 (0.9-2.3)	1.8 (1.1-2.7)	1.4 (0.8-2.2)	0.006	0.056	0.129
GDNF mRNA (median [IQR])	1.0 (0.7-1.6)	1.2 (0.8-1.5)	0.9 (0.7-1.7)	1.8 (1.0-2.9)	1.6 (1.1-3.0)	1.9 (0.9-2.9)	< 0.001	0.404	0.992
TRPV1 mRNA (median [IQR])	1.0 (0.6-1.5)	1.1 (0.8-1.6)	0.9 (0.6-1.2)	1.4 (0.9-2.3)	1.4 (0.9-2.2)	1.4 (0.8-2.3)	0.006	0.102	0.584

¹Mann-Whitney test was used;

²Male vs female. FD: Functional dyspepsia; GDNF: Glial cell-line derived neurotrophic factor; IQR: Interquartile range; NGF: Nerve growth factor; PDS: Postprandial distress syndrome; TRPV1: Transient receptor potential vanilloid receptor 1.

Table 3 Expression of plasma ghrelin, gastric peproghrelin and nociception-related genes in different gender

Variables	Male			Female
Variables	Control (n = 38)	FD (n = 39)	P value¹	Control (n = 49)	FD (n = 65)	P value¹
Plasma acylghrelin (fmol/mL, median [IQR])	15.9 (9.2-33.7)	10.4 (6.5-18.4)	0.017	12.2 (9.0-18.6)	11.4 (6.8-16.5)	0.348
Plasma des-acylghrelin (fmol/mL, median [IQR])	108.0 (31.8-212.9)	58.5 (28.9-134.3)	0.302	65.4 (38.2-111.0)	63.6 (32.2-108.0)	0.844
Ghrelin mRNA (median [IQR])	2.1 (0.5-4.2)	1.9 (0.4-9.1)	0.428	3.2 (1.0-6.1)	1.5 (0.3-4.7)	0.092
NGF mRNA (median [IQR])	1.2 (0.7-1.8)	1.8 (1.1-2.7)	0.002	0.9 (0.5-1.6)	1.4 (0.8-2.2)	0.119
GDNF mRNA (median [IQR])	1.2 (0.7-1.5)	1.6 (1.1-3.0)	0.003	0.9 (0.7-1.7)	1.9 (0.9-2.9)	0.018
TRPV1 mRNA (median [IQR])	1.1 (0.8-1.6)	1.4 (0.9-2.2)	0.014	0.9 (0.6-1.2)	1.4 (0.8-2.3)	0.089

1 Mann-Whitney test was used. FD: Functional dyspepsia; GDNF: Glial cell-line derived neurotrophic factor; IQR: Interquartile range; NGF: Nerve growth factor; PDS: Postprandial distress syndrome; TRPV1: Transient receptor potential vanilloid receptor 1.

Table 4 Dyspepsia symptoms, stool consistency and bowel movement between males and females

Symptoms	Male FD (n = 39)	Female FD (n = 65)	P value¹
Overall abdominal pain² (mean ± SE)	3.4 ± 0.1	3.1 ± 0.2	0.195
Early satiation (mean ± SE)	2.8 ± 0.5	2.5 ± 0.3	0.434
Postprandial fullness (mean ± SE)	3.2 ± 0.3	3.1 ± 0.2	0.221
Epigastric burning/pain (mean ± SE)	2.7 ± 0.2	3.5 ± 0.1	0.047
Bloating (mean ± SE)	2.6 ± 0.3	2.2 ± 0.2	0.339
Nausea (mean ± SE)	1.5 ± 0.3	1.8 ± 0.2	0.327
Vomiting (mean ± SE)	0.5 ± 0.2	0.6 ± 0.1	0.203
BSFS (mean ± SE)	4.8 ± 0.2	4.4 ± 0.2	0.103
Number (per week) (mean ± SE)	4.8 ± 0.3	4.5 ± 0.2	0.532

¹t-test was used;

²Pain not restricted to the epigastric area. BSFS: Bristol stool form score (from 1 = very hard to 7= watery); FD: Functional dyspepsia.

Table 5 HADS and WHOQOL-BREF scores in the control and functional dyspepsia groups according to gender

Variables	Control			FD			P value¹
	Total	Male	Female	Total	Male	Female	Control vs FD	Control²	FD²
	(n = 87)	(n = 38)	(n = 49)	(n = 104)	(n = 39)	(n = 65)	Control vs FD	Control²	FD²
HADS score³ (mean ± SE)
Total	11.0 ± 0.8	10.8 ± 1.2	11.2 ± 1.1	15.8 ± 1.2	13.2 ± 1.3	18.6 ± 2.1	0.001	0.780	0.029
Anxiety	5.1 ± 0.4	4.9 ± 0.6	5.3 ± 0.6	7.4 ± 0.7	6.0 ± 0.7	9.0 ± 1.3	0.005	0.587	0.036
Depression	5.9 ± 0.4	5.9 ± 0.7	5.9 ± 0.6	8.4 ± 0.6	7.2 ± 0.8	9.7 ± 1.0	0.001	0.984	0.047
WHOQOL-BREF score⁴ (mean ± SE)
Total	59.5 ± 1.6	60.7 ± 2.7	58.0 ± 1.5	54.0 ± 1.9	57.5 ± 1.9	51.6 ± 2.1	0.027	0.417	0.074
Overall quality of life and general health	6.2 ± 0.2	6.6 ± 0.3	5.8 ± 0.3	5.9 ± 0.3	6.5 ± 0.3	5.4 ± 0.3	0.278	0.080	0.020
Physical domain	13.4 ± 0.4	13.6 ± 0.7	13.1 ± 0.4	12.6 ± 0.4	13.6 ± 0.5	11.6 ± 0.7	0.185	0.575	0.016
Psychological domain	12.8 ± 0.4	13.2 ± 0.7	12.4 ± 0.5	11.8 ± 0.4	12.4 ± 0.5	11.4 ± 0.7	0.092	0.410	0.278
Social domain	13.7 ± 0.4	14.0 ± 0.6	13.3 ± 0.4	12.1 ± 0.5	13.0 ± 0.5	11.5 ± 0.6	0.012	0.370	0.064
Environment domain	13.3 ± 0.5	13.3 ± 0.7	13.3 ± 0.6	11.6 ± 0.4	12.1 ± 0.5	11.7 ± 0.7	0.010	0.990	0.617

¹t-test was used;

²Between males and females;

³Higher score denotes more severe symptom;

⁴Higher score denotes better quality of life. FD: Functional dyspepsia; HADS: Hospital anxiety and depression scale; WHOQOL-BREF: World health organization quality of life abbreviated version.

Citation: 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
URL: https://www.wjgnet.com/1007-9327/full/v23/i45/8053.htm
DOI: https://dx.doi.org/10.3748/wjg.v23.i45.8053