Predictive Factors for Future Onset of Reflux Esophagitis: A Longitudinal Case-control Study Using Health Checkup Records.
Predictive Factors for Future Onset of Reflux Esophagitis: A Longitudinal Case-control Study Using Health Checkup Records.
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DOI：
10.5056/jnm20237
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发表时间：
2022-01-30
影响因子：
3.4
通讯作者：
Joh T
中科院分区：
文献类型：
--
作者：
Toki Y;Yamauchi R;Kayashima E;Adachi K;Kishi K;Suetsugu H;Wada T;Endo H;Yamada H;Osaga S;Kamiya T;Nakada K;Iwakiri K;Haruma K;Joh T
尽管反流性食管炎 (RE) 的危险因素已在大量横断面研究中进行了调查，但人们对与 RE 未来发病相关的预测因素知之甚少。我们利用健康检查记录，通过纵向病例对照研究调查了 RE 发作前临床参数的时间进程。我们使用了2004年4月至2014年3月期间在日本9个机构的健康检查记录。进行多变量逻辑回归分析以评估基线临床参数与 RE 的关联。通过重复测量分析或纵向多变量逻辑分析的混合效应模型将RE受试者的临床参数的时间过程与非RE受试者的临床参数的时间进程进行比较。初始数据来自 230 056 名个体，最终将 2066 名 RE 受试者和 4132 名非 RE 受试者纳入分析。体重指数、丙氨酸氨基转移酶、吸烟、胃酸反流症状、食管裂孔疝和基线时无萎缩性胃炎与 RE 独立相关。 RE组的体重指数、空腹血糖、甘油三酯、天冬氨酸转氨酶、丙氨酸转氨酶、γ-谷氨酰转肽酶、胃酸反流症状百分比、饱腹感和食管裂孔疝的时程明显差于非RE组。与非 RE 组相比，RE 组在 RE 发病前 5 年表现出与生活方式疾病相关的临床参数恶化更大，包括肥胖、糖尿病、高脂血症和脂肪肝。这些结果表明 RE 是一种生活方式疾病，因此对高危人群进行生活方式指导可能有助于预防 RE 发生。
Although risk factors of reflux esophagitis (RE) have been investigated in numerous cross-sectional studies, little is known about predictive factors associated with future onset of RE. We investigated time courses of clinical parameters before RE onset by a longitudinal case-control study using health checkup records. We used health checkup records between April 2004 and March 2014 at 9 institutions in Japan. A multivariate logistic regression analysis was performed to evaluate associations of baseline clinical parameters with RE. The time courses of the clinical parameters of RE subjects were compared with those of non-RE subjects by the mixed-effects models for repeated measures analysis or longitudinal multivariate logistic analysis. Initial data were obtained from 230 056 individuals, and 2066 RE subjects and 4132 non-RE subjects were finally included in the analysis. Body mass index, alanine aminotransferase, smoking, acid reflux symptoms, hiatal hernia, and absence of atrophic gastritis at baseline were independently associated with RE. The time courses of body mass index, fasting blood sugar, triglyceride, aspartate aminotransferase, alanine aminotransferase, γ-glutamyl transpeptidase, percentages of acid reflux symptoms, feeling of fullness, and hiatal hernia in the RE group were significantly worse than in the non-RE group. The RE group displayed a greater worsening of the clinical parameters associated with lifestyle diseases, including obesity, diabetes, hyperlipidemia, and fatty liver for 5 years before RE onset compared with the non-RE group. These results suggest that RE is a lifestyle disease and thus lifestyle guidance to at-risk person may help to prevent RE onset.
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影响因子：
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