Obesity is an independent risk factor for GERD symptoms and erosive esophagitis
Obesity is an independent risk factor for GERD symptoms and erosive esophagitis
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DOI：
10.1111/j.1572-0241.2005.41703.x
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发表时间：
2005-06-01
影响因子：
9.8
通讯作者：
Rabeneck, L
中科院分区：
文献类型：
--
作者：
El-Serag, HB;Graham, DY;Rabeneck, L
简介：据报道，肥胖与胃食管反流病症状之间存在关联；然而，研究结果并不一致，并且不知道在调整其他已知的 GERD 风险因素后，这种关联是否仍然存在。方法：我们进行了一项横断面研究，以确定志愿者（VA 员工）中 GERD 的患病率和风险因素。参与者完成了胃食管反流调查问卷、Block 98 食物频率调查问卷，提供了身高和体重信息，并被邀请进行上消化道内窥镜检查和活检。通过调整年龄、性别、种族、GERD 症状、饮食摄入量、教育水平、GERD 家族史、幽门螺杆菌感染以及胃炎的存在和分布，在多元逻辑回归分析中分别检查体重指数 (BMI) 与 GERD 症状和糜烂性食管炎的关联。 结果：453 人（平均年龄 44 岁，70% 女性和 43% 黑人）提供了有关胃灼热、反流和胃灼热的完整信息。 BMI（915 名接受调查问卷的人中的 50%）。在 196 名接受内窥镜检查的患者中，44 名（22%）患有食管糜烂，118 名（26%）报告至少每周出现胃灼热或反流。观察到胃灼热或反流频率与较高体重指数之间的剂量反应关系。与每周没有症状的参与者相比，有这些症状的 118 名参与者中超重（BMI 25-30）（35% vs 32%）或肥胖（BMI > 30）（39% vs 26%）的比例显着增加，线性趋势 p 为 0.004。相对于没有食管糜烂的人，有糜烂的人更可能超重（39% vs 26%）或肥胖（41% vs 32%），p = 0.04。肥胖参与者出现反流症状或食管糜烂的可能性是 BMI 正常 (< 25) 参与者的 2.5 倍。调整潜在混杂因素后，BMI 和 GERD 症状之间的关联在方向和程度上仍然存在。结论：超重和肥胖是 GERD 症状和食管糜烂的强大独立危险因素。饮食摄入量或组成似乎不能解释这些发现。
INTRODUCTION: An association between obesity and GERD symptoms has been reported; however, study results have been inconsistent and it is not known whether an association persists after adjusting for other known GERD risk factors.METHODS: We carried out a cross-sectional study to determine the prevalence and risk factors of GERD in volunteers (VA employees). Participants completed a Gastroesophageal Reflux Questionnaire, the Block 98 Food Frequency Questionnaire, provided height and weight information, and were invited for upper endoscopy with biopsies. Associations of body mass index (BMI) with GERD symptoms and erosive esophagitis were examined separately in multiple logistic regression analyses adjusting for age, sex, race, GERD symptoms, dietary intake, education level, family history of GERD, H. pylori infection, and the presence and distribution of gastritis.RESULTS: Four hundred and fifty-three persons (mean age 44 yr, 70% women and 43% black) provided complete information on heartburn, regurgitation, and BMI (50% of 915 who received questionnaires). Of the 196 who underwent endoscopy, 44 (22%) had esophageal erosions and 118 (26%) reported at least weekly heartburn or regurgitation. A dose-response relationship between frequency of heartburn or regurgitation and higher BMI was observed. Compared to participants without weekly symptoms, a significantly larger proportion of the 118 with these symptoms were either overweight (BMI 25-30) (35%vs 32%) or obese (BMI > 30) (39%vs 26%), p for linear trend 0.004. Relative to those with no esophageal erosions, those with erosions were more likely to be overweight (39%vs 26%) or obese (41%vs 32%), p= 0.04. Obese participants were 2.5 times as likely as those with normal BMI (< 25) to have reflux symptoms or esophageal erosions. The association between BMI and GERD symptoms persisted in direction and magnitude after adjustment for potential confounders.CONCLUSIONS: Overweight and obesity are strong independent risk factor of GERD symptoms and esophageal erosions. The amount or composition of dietary intake does not appear to be a likely explanation for these findings.