S1073 How the Subgroups in Functional Dyspepsia Affect the Quality of Life and Therapeutic Approaches. Experience from Japanese Mega Study (JMMS)

Abstract

active gastritis, dysplasia, or cancer. Results: The 1010 identified cases had a mean age of 50 ± 14 and included 618 (61%) women, 549 (54%) Hispanics, 283 (28%) Asians, 68 (7%) Blacks, and 55 (5%) Whites. Significant esophageal pathology (EP) was uncovered in 186 (18%) individuals and significant gastric pathology (GP) in 114 (11%), including PUD in 35 (3.5%). More men had EP than women (22% vs 16%; p=0.008). However, women born in the US were more likely to have EP than those who immigrated to the US (36% vs 14%; p=0.004). Hispanic women were more likely to have EP than non-Hispanics (17% vs 11%; p=0.046). Men had more GP than women (15% vs 9%; p=0.001). Blacks were more likely to have GP than non-Blacks (21% vs 11%; p=0.013), including a higher rate of PUD (8.8% vs 3.2%; p=0.03), despite no difference in H. pylori prevalence (47% vs 45%; p=0.47). Asians were also more likely to have GP than non-Asians (17% vs 9%; p<0.001), despite no difference in H. pylori prevalence (43% vs 48%; p=0.47). In particular, Asian men were more likely to have GP than non-Asian men (22% vs 12%; p=0.008). Overall, men were significantly more likely to have both EP and GP than women (35% vs 23%; p<0.001). In multivariate logistic regression analysis controlling for age, H. pylori status, ethnicity, and country of birth, male gender remained a significant predictor of esophageal pathology (OR 2.0 CI 1.2-3.2; p=0.006). In a similar multivariate logistic regression model, both male gender (OR 1.8 CI 1.0-3.0; p=0.049) and Asian ethnicity (OR 2.8 CI 1.5-5.2; p=0.001) remained significant predictors of gastric pathology. Conclusion: In this ethnically diverse cohort with dyspepsia, EGD revealed significant pathology independent of H. pylori status. Male gender and Asian ethnicity remained significant independent predictors for pathology. Further studies assessing predictors of endoscopic findings in ethnically diverse cohorts are warranted.