Iwasaki Eisuke, Suzuki Hidekazu, Sugino Yoshinori, Iida Tsutomu, Nishizawa Toshihiro, Masaoka Tatsuhiro, Hosoda Hiroshi, Kangawa Kenji, Hibi Toshifumi
Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medcine, Shinjuku-ku, Tokyo, Japan.
J Gastroenterol Hepatol. 2008 Dec;23 Suppl 2:S216-21. doi: 10.1111/j.1440-1746.2008.05441.x.
Body mass index (BMI) and obesity are reportedly associated with symptoms of gastroesophageal reflux disease (GERD). The present study was designed to investigate the effect of metabolic disorders including obesity on the levels of functional gastroesophageal reflux by videoesophagography.
Twenty-one patients with GERD-associated symptoms were examined by videoesophagography. On their initial visit, all patients completed the Japanese version of the Carlsson-Dent self-administered questionnaire (QUEST). The findings of videoesophagography were evaluated by the X-ray severity scores for gastroesophageal reflux (XRSS), which were defined for the total diagnosis of functional gastroesophageal reflux. Correlation between XRSS scores and physical or metabolic markers was evaluated.
The mean XRSS in the QUEST-positive group (4.7+/-0.6) was significantly higher than that in the QUEST-negative group (3.3+/-0.5, P<0.05). XRSS correlated positively with BMI (P<0.05) and waist circumference (P<0.05), but negatively with high-density lipoprotein-cholesterol (P<0.05), serum adiponectin (P<0.05) and active ghrelin (P<0.05). In the multivariate analysis, serum adiponectin level, BMI and triglyceride independently affected the XRSS.
Videoesophagography is a useful diagnostic modality for the evaluation of patients with GERD symptoms. Functional gastroesophageal reflux is seen in obese patients, especially with decreased levels of adiponectin.
据报道，体重指数（BMI）和肥胖与胃食管反流病（GERD）症状相关。本研究旨在通过视频食管造影术调查包括肥胖在内的代谢紊乱对功能性胃食管反流水平的影响。
对21例有GERD相关症状的患者进行视频食管造影检查。在初次就诊时，所有患者均完成了日语版的卡尔森-登特自评问卷（QUEST）。通过胃食管反流的X线严重程度评分（XRSS）评估视频食管造影的结果，该评分用于功能性胃食管反流的总体诊断。评估XRSS评分与身体或代谢指标之间的相关性。
QUEST阳性组的平均XRSS（4.7±0.6）显著高于QUEST阴性组（3.3±0.5, P<0.05）。XRSS与BMI（P<0.05）和腰围（P<0.05）呈正相关，但与高密度脂蛋白胆固醇（P<0.05）、血清脂联素（P<0.05）和活性胃饥饿素（P<0.05）呈负相关。在多变量分析中，血清脂联素水平、BMI和甘油三酯独立影响XRSS。
视频食管造影术是评估有GERD症状患者的一种有用诊断方法。功能性胃食管反流在肥胖患者中可见，尤其是脂联素水平降低的患者。
