El-Serag Hashem B, Tran Thomas, Richardson Peter, Ergun Gulchin
Sections of Health Services Research and Gastroenterology, Houston Veterans Affairs Medical Center and Baylor College of Medicine, Houston, Texas 77030, USA.
Scand J Gastroenterol. 2006 Aug;41(8):887-91. doi: 10.1080/00365520500535402.
Obesity may increase intra-abdominal pressure on the stomach leading to an increase in intragastric pressure, which in turn induces lower esophageal sphincter relaxation, with subsequent reflux. However, the association between anthropometric measures of total body as well as abdominal obesity and intragastric pressure has not been examined.
This prospective cross-sectional study included consecutive patients undergoing manometry at an open access Reflux Center. Standardized measurements of body-weight, height, and waist and hip circumference were prospectively obtained. To assess the intragastric pressure, the perfusion port levels of the catheter were verified to be at the same vertical height (0 mmHg) inside the patient as they were outside the patient during calibration. Correlation between gastric pressure and anthropometric measures was calculated and adjusted for demographic features and presenting symptoms.
A total of 322 patients (67% women) with a mean age of 52.5 years were enrolled. The mean values for weight, height, and body mass index (BMI) were 77.2 kg, 168 cm, and 27.5 kg/m2, respectively (range 16.0-52.0, median 27.0). The mean intragastric pressure was 2.9 cm H2O (SD: 1.7). There was a weak, positive correlation between gastric pressure and both BMI (r=0.11, p=0.05) and waist circumference (r=0.11, p=0.06). The associations between gastric pressure and both BMI and waist circumference were relatively unaffected by adjusting for several variables including age, indications for manometry, race, and gender in a multivariable linear regression model. For each unit increase in BMI, there was approximately a 10% increase in intragastric pressure.
In this study of consecutive patients with wide-ranging BMI values, there was a weak, positive correlation between intragastric pressure and both BMI and waist circumference. This indicates that obesity operates to increase the risk of gastroesophageal reflux disease (GERD) at least partly by increasing intragastric pressure.
肥胖可能会增加对胃部的腹内压，导致胃内压升高，进而引起食管下括约肌松弛，随后出现反流。然而，全身及腹部肥胖的人体测量指标与胃内压之间的关联尚未得到研究。
这项前瞻性横断面研究纳入了在一家开放就诊的反流中心连续接受测压的患者。前瞻性地获取了体重、身高以及腰围和臀围的标准化测量值。为评估胃内压，在校准期间，导管的灌注端口水平在患者体内和体外时被验证处于相同的垂直高度（0 mmHg）。计算胃内压与人体测量指标之间的相关性，并针对人口统计学特征和呈现的症状进行调整。
共纳入322例患者（67%为女性），平均年龄52.5岁。体重、身高和体重指数（BMI）的平均值分别为77.2 kg、168 cm和27.5 kg/m²（范围为16.0 - 52.0，中位数为27.0）。平均胃内压为2.9 cm H₂O（标准差：1.7）。胃内压与BMI（r = 0.11，p = 0.05）和腰围（r = 0.11，p = 0.06）之间均存在微弱的正相关。在多变量线性回归模型中，对包括年龄、测压指征、种族和性别等多个变量进行调整后，胃内压与BMI和腰围之间的关联相对不受影响。BMI每增加一个单位，胃内压大约增加10%。
在这项对BMI值范围广泛的连续患者的研究中，胃内压与BMI和腰围之间均存在微弱的正相关。这表明肥胖至少部分通过增加胃内压来增加胃食管反流病（GERD）的风险。
