功能性消化不良(FD)被定义为在没有可能解释症状的器质性疾病的情况下存在胃十二指肠症状。关节过度活动(JH)是指关节的被动或主动运动增加超出其正常范围,并且在关节过度活动综合征(JHS)患者中具有特征性表现。这是一种Ehlers-Danlos综合征(EDS)的高流动性亚型。最近的报道强调了FD与Ehlers-Danlos综合征的共存。我们的目的是研究与健康受试者相比,FD中JHS的患病率,并研究共存的JHS对胃动力的影响。营养耐受性,FD的消化不良症状。
FD患者填写了消化不良症状严重程度评分。在胃内输注营养饮料(ND,1.5千卡/毫升,60ml/min),直到健康受试者和FD的最大饱腹感。我们比较了有或没有JHS的HS和FD的IGP谱和养分耐受性。
54%的FD患者(n=39,41.2±2.2岁)和7%的健康受试者(n=15,27.3±2.3岁)存在JHS。与JHS-FD和HS相比,非JHS-FD的IGP下降和养分耐受性较低(AUCJHS-FD:-17.9±2.5vs.非JHS-FD:-13.0±3.3mmHgmin,p=0.2,HS:-19.6±2.9mmHgmin;ND容差非JHS-FD:671.0±96.0vs.JHS-FD:842.7±105.7大卡,p=0.25,HS:980.0±108.1大卡)。
JHS经常与FD共存。与JHS-FD相比,非JHS-FD的特征是适应性降低和养分耐受性降低。Clinicaltrials.gov,参考号NCT04279990。
Functional dyspepsia (FD) is defined as the presence of gastroduodenal symptoms in the absence of organic disease that is likely to explain the symptoms. Joint hypermobility (JH) refers to the increased passive or active movement of a joint beyond its normal range and is characteristically present in patients with joint hypermobility syndrome (JHS), which is a hypermobile subtype of Ehlers-Danlos syndrome (EDS). Recent reports have highlighted the co-existence of FD with Ehlers-Danlos syndrome. Our aim was to study the prevalence of JHS in FD compared with healthy subjects and to study the impact of co-existing JHS on gastric motility, nutrient tolerance, and dyspeptic symptoms in FD.
FD patients filled out a dyspepsia symptom severity score. Intragastric pressure (IGP) was measured with high-resolution manometry (HRM) during the intragastric infusion of nutrition drink (ND, 1.5 Kcal/ml, 60 ml/min) until maximal satiation in healthy subjects and FD. We compared IGP profiles and nutrient tolerance in HS and FD with or without JHS.
JHS was present in 54% of FD patients (n = 39, 41.2 ± 2.2 years old) and 7% of healthy subjects (n = 15, 27.3 ± 2.3 years old). IGP drop and nutrient tolerance were lower in non-JHS-FD compared with JHS-FD and HS (AUC JHS-FD: -17.9 ± 2.5 vs. non-JHS-FD: -13.0 ± 3.3 mmHg min, p = 0.2, HS:-19.6 ± 2.9 mmHg min; ND tolerance non-JHS-FD: 671.0 ± 96.0 vs. JHS-FD: 842.7 ± 105.7 Kcal, p = 0.25, HS: 980.0 ± 108.1 Kcal).
JHS often co-exists with FD. Non-JHS-FD was characterized by decreased accommodation and lower nutrient tolerance characterized compared with JHS-FD. Clinicaltrials.gov, reference number NCT04279990.