The association between objective tongue color and endoscopic findings: results from the Kyushu and Okinawa population study (KOPS).
The association between objective tongue color and endoscopic findings: results from the Kyushu and Okinawa population study (KOPS).
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DOI：
10.1186/s12906-015-0904-0
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发表时间：
2015-10-16
影响因子：
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通讯作者：
Hayashi J
中科院分区：
文献类型：
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作者：
Kainuma M;Furusyo N;Urita Y;Nagata M;Ihara T;Oji T;Nakaguchi T;Namiki T;Hayashi J
舌色与胃食管疾病的关系尚不清楚。本研究旨在探讨舌色（TC）、内镜检查结果、幽门螺杆菌感染状况和血清学萎缩性胃炎（SAG）之间的关系。研究对象为冲绳石垣岛896名居民，年龄28-86岁。对患者进行舌象、食管胃镜检查和血清幽门螺杆菌抗体检测。SAG定义为血清胃蛋白酶原（PG）I水平≤70 ng/ml且PGI/II比值≤3.0。TC通过独立于设备的国际照明委员会1976 L*a*B* 色空间标准在四个点测量：（1）边缘，（2）后部，（3）中部，和（4）顶点。我们还计算了舌边缘与其他三个测量点的比值，以检查舌苔与内窥镜和实验室检查结果之间的关联。排除了有两个或两个以上内镜检查结果的参与者（n = 315）或有SAG但没有幽门螺杆菌血清阳性的参与者（n = 33）。其余548名参与者被分为三组：SAG和幽门螺杆菌血清阳性（n = 67），血清阳性的幽门螺杆菌（n = 56），没有SAG和幽门螺杆菌血清阴性（n = 425）。我们将425名居民分为单一内镜检查结果阳性组（n = 207）和阴性组（作为对照组）（n = 218）。最常见的单一内镜检查结果是食管疝（n = 110），其次是糜烂性食管炎（n = 35）和糜烂性胃炎（EG）（n = 45）。EH与TC（2b*/1b*）显著相关（P < 0.05）。EG与TC（3a*，3b*）显著相关（P < 0.05）。幽门螺杆菌阳性与TC（3L *，3L */1 L*）显著相关（P < 0.05，<0.01），幽门螺杆菌和SAG阳性与TC（3L */1 L*）显著相关（P < 0.05）。多因素分析提取TC（3a*，3b*）作为与EG鉴别诊断相关的独立因素（比值比（OR）2.66 P = 0.008，OR 2.17 P = 0.045）。中部舌体颜色反映胃粘膜急性变化，如糜烂性胃炎。舌诊将是一个有用的，非侵入性的筛查工具，EG。
The relation between tongue color and gastroesophageal disease is unclear. This study was done to investigate the associations between tongue color (TC), endoscopic findings, Helicobacter.pylori infection status, and serological atrophic gastritis (SAG). The participants were 896 residents of Ishigaki Island, Okinawa, aged 28–86 years. The tongue was photographed, esophagogastroduodenoscopy was done, and serum antibody to H.pylori was measured. SAG was defined as a serum Pepsinogen (PG)Ilevel ≤70 ng/ml and a PGI/IIratio ≤3.0. TC was measured by the device-independent international commission on Illumination 1976 L*a*b* color space standards at four points: (1) edge, (2) posterior, (3) middle, and (4) apex. We also calculated the ratio of the tongue edge to the three other measured points to examine the association between the coating of the tongue and the endoscopic and laboratory findings. Participants were excluded who had two or more endoscopic findings (n = 315) or who had SAG without seropositivity to H.pylori (n = 33). The remaining 548 participants were divided into three groups: SAG and seropositive to H.pylori (n = 67), seropositive to H.pylori alone (n = 56), and without SAG and seronegative for H.pylori (n = 425). We divided 425 residents into a single endoscopic finding positive group (n = 207) and a negative group, which served as a control (n = 218). The most frequent single endoscopic finding was esophageal hernia (n = 110), followed by erosive esophagitis (n = 35) and erosive gastritis (EG) (n = 45). EH was significantly associated with TC (2b*/1b*) (P < 0.05). EG was significantly associated with TC (3a*, 3b*) (P < 0.05). Seropositivity to H.pylori was significantly associated with TC (3 L*, 3 L*/1 L*) (P < 0.05, <0.01), and seropositivity to both H.pylori and SAG was significantly associated with TC (3 L*/1 L*) (P < 0.05). Multivariate analysis extracted TC (3a*, 3b*) as an independent factor associated with a differential diagnosis of EG (Odds ratio (OR) 2.66 P = 0.008, OR 2.17 P = 0.045). The tongue body color of the middle area reflects acute change of gastric mucosa, such as erosive gastritis. Tongue diagnosis would be a useful, non-invasive screening tool for EG.