肠易激综合征患者的饮食习惯、焦虑和抑郁:临床和实验室比较

O. Gaus, M. Livzan, О.В. Гаус, М.А. Ливзан
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引用次数: 0

摘要

目的:评估肠易激综合征患者的应激激素(唾液中的皮质醇)、神经递质(血清中的血清素、血浆中的多巴胺)水平与饮食习惯、焦虑和抑郁水平的关系。材料和方法。一项开放队列前瞻性研究纳入263例确诊为肠易激综合征的患者,其中189例(71.9%)为女性,74例(28.1%)为男性。IBS患者的平均年龄为29岁[25岁;35年。对照组包括40名健康志愿者。使用WHO CINDI项目问卷、“营养和饮食行为信息”评估所有参与研究的个体的饮食和饮食习惯,根据HADS问卷评估焦虑和抑郁的严重程度,根据VSI问卷评估与胃肠道症状相关的特定焦虑水平,根据IBS-QoL问卷评估生活质量。此外,采用酶免疫分析法评估了唾液早晚部分的皮质醇水平、血清中的血清素和血浆中的多巴胺水平。与对照组相比,IBS患者唾液早晚部分皮质醇水平(U = 19.5, p < 0.001)、血清血清5 -羟色胺水平(U = 269.0, p = 0.042)、血浆多巴胺水平(U = 93.5, p = 0.0002)均显著升高。IBS患者的平均唾液皮质醇水平为45.39 [29.86;上午为70.10 ng/ml, 19.21 ng/ml [13.98;夜间为23.50]ng/ml,健康组为19.0 [16.5;21.7]和9.7 [8.5];10.5] ng/ml。IBS患者血清血清5 -羟色胺平均含量为188.78 [150.41;230.32] ng/ml,健康人142.80 [130.52;154.15 ng / ml。IBS患者血浆多巴胺平均含量28.83 [20.08;41.54] ng/ml,健康人- 58.20 [48.15;66.62 ng / ml.Conclusion。IBS患者的应激激素(皮质醇)和神经递质(血清素、多巴胺)的分泌与营养的性质、焦虑和抑郁的水平密切相关,也与病程的临床变异和严重程度有关。
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Eating Habits, Anxiety and Depression in Patients with Irritable Bowel Syndrome: Clinical and Laboratory Comparisons
Aim: to assess the level of stress hormones (cortisol in saliva), neurotransmitters (serotonin in blood serum, dopamine in blood plasma) in relation to eating habits, anxiety and depression levels in patients with IBS.Materials and methods. An open cohort prospective study was conducted with the inclusion of 263 patients with an established diagnosis of IBS, among them 189 (71.9 %) women and 74 (28.1 %) men. The average age of patients with IBS was 29 [25; 35] years. The control group included 40 healthy volunteers. All individuals included in the study were assessed for diet and eating habits using the WHO CINDI program questionnaire, “Information on Nutrition and Eating Behavior”, the severity of anxiety and depression according to the HADS questionnaire, the level of specific anxiety in relation to gastrointestinal symptoms according to the VSI questionnaire, quality of life according to the IBS-QoL questionnaire. In addition, the enzyme immunoassay method was used to assess the levels of cortisol in the morning and evening portions of saliva, serotonin in the blood serum and dopamine in the blood plasma.Results. Among patients with IBS there is a statistically significantly higher level of cortisol in the morning and evening portions of saliva (U = 19.5, p < 0.001 and U = 111.5, p < 0.001, respectively), serotonin in blood serum (U = 269.0, p = 0.042) and lower plasma dopamine levels (U = 93.5, p = 0.0002) compared with controls. The mean salivary cortisol level among patients with IBS was 45.39 [29.86; 70.10] ng/ml in the morning and 19.21 [13.98; 23.50] ng/ml in the evening, while in the group of healthy individuals it was 19.0 [16.5; 21.7] and 9.7 [8.5; 10.5] ng/ml, respectively. The average content of serotonin in blood serum in patients with IBS was 188.78 [150.41; 230.32] ng/ml, among healthy individuals — 142.80 [130.52; 154.15] ng/ml. The average content of dopamine in blood plasma in patients with IBS was 28.83 [20.08; 41.54] ng/ml, in healthy individuals — 58.20 [48.15; 66.62] ng/ml.Conclusion. In patients with IBS the secretion of the stress hormone (cortisol) and neurotransmitters (serotonin, dopamine) is closely related to the nature of nutrition, the level of anxiety and depression, and is also associated with the clinical variant and severity of the course of the disease.
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