目的 基于脑-肠轴水平探究儿童功能性消化不良（functional dyspepsia，FD）与降钙素基因相关肽（calcitonin gene-related peptide，CGRP）、摄食抑制因子（nesfatin-1）及生长激素释放肽（ghrelin）等脑-肠肽水平的关系。 方法 回顾性选取2019年11月至2020年12月就诊于中国医科大学附属盛京医院FD患儿38例纳入FD组，另选取健康儿童34例纳入健康对照组。采集两组患儿的血清标本，应用酶联免疫吸附测定法分别测定两组儿童CGRP、ghrelin及nesfatin-1的血清水平并进行比较。同时对FD患儿FD症状进行评分，采用Spearman秩相关分析症状评分与脑-肠肽血清水平的相关性。 结果 FD组患儿血清nesfatin-1和CGRP水平均高于健康对照组（P<0.05）；两组血清ghrelin水平差异无统计学意义（P>0.05）。nesfatin-1血清水平与早饱症状评分呈正相关（rs=0.553，P<0.001），与FD总评分未见明显相关性（rs=0.191，P=0.250）；CGRP血清水平与腹痛症状评分呈正相关（rs=0.479，P=0.002），与嗳气症状评分呈正相关（rs=0.619，P<0.001），与FD总评分呈正相关（rs=0.541，P<0.001）。 结论 CGRP及nesfatin-1在FD的病理生理过程中可能发挥重要作用。
Abstract
Objective To study the association between functional dyspepsia (FD) and serum levels of brain-gut peptides including calcitonin gene-related peptide (CGRP), nesfatin-1, and ghrelin in children. Method A total of 38 children with FD who attended Shengjing Hospital of China Medical University from November 2019 to December 2020 were enrolled as the FD group. Thirty-four healthy children were enrolled as the control group. Serum samples were collected from all of the children. Enzyme-linked immunosorbent assay was used to measure serum levels of CGRP, ghrelin, and nesfatin-1 for comparison between the two groups. The scores of clinical symptoms were determined for the children with FD. Spearman rank correlation analysis was used to investigate the correlation of symptom scores with the serum levels of brain-gut peptides. Results The FD group had significantly higher serum levels of nesfatin-1 and CGRP than the control group (P<0.05), while there was no significant difference in the serum level of ghrelin between the two groups (P>0.05). The serum level of nesfatin-1 was positively correlated with the symptom score of early satiety (rs=0.553, P<0.001), but was not significantly correlated with the total score of FD (rs=0.191, P=0.250). The serum level of CGRP was positively correlated with the scores of abdominal pain (rs=0.479, P=0.002) and belching (rs=0.619, P<0.001) and the total score of FD (rs=0.541, P<0.001). Conclusions CGRP and nesfatin-1 may play an important role in the pathophysiological process of FD.
关键词
功能性消化不良 /
降钙素基因相关肽 /
摄食抑制因子 /
生长激素释放肽 /
儿童
Key words
Functional dyspepsia /
Calcitonin gene-related peptide /
Nesfatin-1 /
Ghrelin /
Child
{{custom_sec.title}}
{{custom_sec.title}}
{{custom_sec.content}}
参考文献
1 Ding JH, Jin Z, Yang XX, et al. Role of gut microbiota via the gut-liver-brain axis in digestive diseases[J]. World J Gastroenterol, 2020, 26(40): 6141-6162. PMID: 33177790. PMCID: PMC7596643. DOI: 10.3748/wjg.v26.i40.6141.
2 Butler MI, Cryan JF, Dinan TG. Man and the microbiome: a new theory of everything?[J]. Annu Rev Clin Psychol, 2019, 15: 371-398. PMID: 30786244. DOI: 10.1146/annurev-clinpsy-050718-095432.
3 Liu J, Li F, Tang XD, et al. XiangshaLiujunzi decoction alleviates the symptoms of functional dyspepsia by regulating brain-gut axis and production of neuropeptides[J]. BMC Complement Altern Med, 2015, 15: 387. PMID: 26508134. PMCID: PMC4623916. DOI: 10.1186/s12906-015-0913-z.
4 He Y, Yang C, Wang P, et al. Child compound Endothelium corneum attenuates gastrointestinal dysmotility through regulating the homeostasis of brain-gut-microbiota axis in functional dyspepsia rats[J]. J Ethnopharmacol, 2019, 240: 111953. PMID: 31082513. DOI: 10.1016/j.jep.2019.111953.
5 Cordner ZA, Li Q, Liu L, et al. Vagal gut-brain signaling mediates amygdaloid plasticity, affect, and pain in a functional dyspepsia model[J]. JCI insight, 2021, 6(6): 144046. PMID: 33591956. PMCID: PMC8026195. DOI: 10.1172/jci.insight.144046.
6 Hyams JS, Di Lorenzo C, Saps M, et al. Functional disorders: children and adolescents[J]. Gastroenterology, 2016, 150(6):1456-1468.e2. PMID: 27144632. DOI: 10.1053/j.gastro.2016.02.015.
7 Kim YS, Lee JS, Lee TH, et al. Plasma levels of acylated ghrelin in patients with functional dyspepsia[J]. World J Gastroenterol, 2012, 18(18):2231-2237. PMID: 22611317. PMCID: PMC3351774. DOI: 10.3748/wjg.v18.i18.2231.
8 Hyams JS, Di Lorenzo C, Saps M, et al. Childhood functional gastrointestinal disorders: child/adolescent[J]. Gastroenterology, 2016, 150(6): 1456-1468.E2. PMID: 27144632. DOI: 10.1053/j.gastro.2016.02.015.
9 Zhu J, Tong H, Ye X, et al. The effects of low-dose and high-dose decoctions of fructus aurantii in a rat model of functional dyspepsia[J]. Med Sci Monit, 2020, 26: e919815. PMID: 32248203. PMCID: PMC7156881. DOI: 10.12659/MSM.919815.
10 徐派的, 张红星, 杨云, 等. 电针对功能性消化不良模型大鼠胃肠动力及VIP和CGRP水平的影响[J]. 中国中西医结合杂志, 2017, 37(3): 360-364. DOI: 10.7661/CJIM.2017.03.0360.
11 M?nnikes H, van der Voort IR, Wollenberg B, et al. Gastric perception thresholds are low and sensory neuropeptide levels high in helicobacter pylori-positive functional dyspepsia[J]. Digestion, 2005, 71(2): 111-123. PMID: 15785037. DOI: 10.1159/000084625.
12 Shindo T, Futagami S, Hiratsuka T, et al. Comparison of gastric emptying and plasma ghrelin levels in patients with functional dyspepsia and non-erosive reflux disease[J]. Digestion, 2009, 79(2): 65-72. PMID: 19246923. DOI: 10.1159/000205740.
13 Lee KJ, Cha DY, Cheon SJ, et al. Plasma ghrelin levels and their relationship with gastric emptying in patients with dysmotility-like functional dyspepsia[J]. Digestion, 2009, 80(1): 58-63. PMID: 19494492. DOI: 10.1159/000215389.
14 Kim YS, Lee JS, Lee TH, et al. Plasma levels of acylated ghrelin in patients with functional dyspepsia[J]. World J Gastroenterol, 2012, 18(18): 2231-2237. PMID: 22611317. PMCID: PMC3351774. DOI: 10.3748/wjg.v18.i18.2231.
15 Tang L, Zeng Y, Li L, et al. Electroacupuncture upregulated ghrelin in rats with functional dyspepsia via AMPK/TSC2/Rheb-mediated mTOR inhibition[J]. Dig Dis Sci, 2020, 65(6): 1689-1699. PMID: 31863340. PMCID: PMC7225202. DOI: 10.1007/s10620-019-05960-5.
16 St-Pierre DH, Martin J, Shimizu H, et al. Association between nesfatin-1 levels and metabolic improvements in severely obese patients who underwent biliopancreatic derivation with duodenal switch[J]. Peptides, 2016, 86: 6-12. PMID: 27681383. DOI: 10.1016/j.peptides.2016.09.014.
17 Zhou XP, Sha J, Huang L, et al. Nesfatin-1/NUCB2 in the amygdala influences visceral sensitivity via glucocorticoid and mineralocorticoid receptors in male maternal separation rats[J]. Neurogastroenterol Motil, 2016, 28(10): 1545-1553. PMID: 27380730. DOI: 10.1111/nmo.12853.
18 Jing FC, Zhang J, Feng C, et al. Potential rat model of anxiety-like gastric hypersensitivity induced by sequential stress[J]. World J Gastroenterol, 2017, 23(42): 7594-7608. PMID: 29204059. PMCID: PMC5698252. DOI: 10.3748/wjg.v23.i42.7594.
PDF(526 KB)
