Overweight is a risk factor for both erosive and non-erosive reflux disease

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• 作者：Edoardo  ; Savarino  ; ;   ; ^{edoardo.savarino@unige.it} ;   ; ^{esavarino@libero.it} ; Patrizia  ; Zentilin ; Elisa  ; Marabotto ; Daria  ; Bonfanti ; Simona  ; Inferrera ; Lorenzo  ; Assandri ; Giorgio  ; Sammito ; Lorenzo  ; Gemignani ; Manuele  ; Furnari ; Pietro  ; Dulbecco ; Vincenzo  ; Savarino
• 关键词：BMI ; Impedance pH-metry ; MII-pH ; Non-acid reflux ; Overweight
• 刊名：Digestive and Liver Disease
• 出版年：2011
• 出版时间：December 2011
• 年：2011
• 卷：43
• 期：12
• 页码：940-945
• 全文大小：336 K

文摘

Introduction

Studies have reported that the association between overweight and erosive oesophagitis is very strong, whilst seeming less consistent with non-erosive reflux disease.

Aim

We have hypothesized that this difference may be due to the heterogeneity of endoscopy-negative population.

Methods

We studied 81 patients with erosive oesophagitis, 48 controls and 295 endoscopy-negative patients classified by impedance-pH-testing as: (1) pH-POS (abnormal acid exposure); (2) hypersensitive oesophagus (normal acid exposure/SAP+); (3) functional heartburn (normal acid exposure/SAP?. Body mass index was also calculated.

Results

Mean body mass index was significantly higher (p < 0.05) in erosive oesophagitis than in endoscopy-negative patients as a whole and controls [27 (18?0) vs. 25 (16?8) vs. 23 (16?4)]. However, the separation of endoscopy-negative patients showed that mean body mass index was higher (p < 0.05) in those with increased acid exposure time [26 (18?5)] than in hypersensitive oesophagus [24 (16?8)]. The former subgroup was similar to erosive oesophagitis, whilst the latter one to both functional heartburn [23 (16?4)] and controls (p = ns). Increased body mass index represented a risk factor for erosive oesophagitis (odds ratio 1.4; 95 % confidence interval, 1.2?.6) and non-erosive reflux disease pH-POS subgroup (odds ratio 1.35; 95 % confidence interval, 1.2?.5).

Conclusion

Our study shows that overweight represents an important risk factor for erosive oesophagitis and pH-POS non-erosive reflux disease and not for hypersensitive oesophagus and functional heartburn. This provides an explanation for the previously reported lesser role of this variable in non-erosive reflux disease population.