Elitsur Yoram, Dementieva Yulia, Elitsur Rotem, Rewalt Mary
Department of Pediatrics, Section of Gastroenterology, Joan C. Edwards School of Medicine, Marshall University, Huntington, West Virginia 25701, USA.
Metab Syndr Relat Disord. 2009 Jun;7(3):211-4. doi: 10.1089/met.2008.0069.
Obesity has been associated with various gastrointestinal diseases in children, but the role of obesity in gastroesophageal reflux disease (GERD) has not been clearly established. The aim of the study was to investigate whether obesity and/or being overweight are risk factors for reflux esophagitis in children. A retrospective analysis of endoscopy charts was reviewed. Demographic, weight, height, and histology results were obtained from each patient. The body mass index (BMI) and BMI Z-score were calculated according to known formula. The diagnosis of GERD was established by histology. The charts of 738 children were reviewed; of these, 345 (47%) children were overweight or obese. Histological findings compatible with GERD were found in 254 (65%) children with normal weight, 111 (69%) overweight children, and 126 (68%) obese children (P > 0.05). Among those reviewed, the mean age of children with normal weight was significantly younger than that of overweight or obese children (P = 0.0001). A single variant analysis showed a significant association between GERD and male gender (P = 0.0001). Multivariant analysis (gender, age, and BMI Z-score) showed that GERD was significantly associated with male gender (P < 0.0001), but not with age (P = 0.443) or BMI Z-score (P = 0.098). In symptomatic children with histologically proven GERD, only male gender was an independent risk factor for GERD, not obesity or being overweight. Large, prospective studies in children that capture a larger spectrum of GERD are clearly warranted.
肥胖已与儿童的多种胃肠道疾病相关，但肥胖在胃食管反流病（GERD）中的作用尚未明确。本研究的目的是调查肥胖和/或超重是否为儿童反流性食管炎的危险因素。对内镜检查图表进行了回顾性分析。从每位患者获取人口统计学、体重、身高和组织学结果。根据已知公式计算体重指数（BMI）和BMI Z评分。GERD的诊断通过组织学确定。回顾了738名儿童的图表；其中，345名（47%）儿童超重或肥胖。在体重正常的254名（65%）儿童、超重的111名（69%）儿童和肥胖的126名（68%）儿童中发现了与GERD相符的组织学结果（P>0.05）。在这些被回顾的儿童中，体重正常儿童的平均年龄显著低于超重或肥胖儿童（P = 0.0001）。单变量分析显示GERD与男性性别之间存在显著关联（P = 0.0001）。多变量分析（性别、年龄和BMI Z评分）显示GERD与男性性别显著相关（P<0.0001），但与年龄（P = 0.443）或BMI Z评分（P = 0.098）无关。在组织学证实为GERD的有症状儿童中，只有男性性别是GERD的独立危险因素，而非肥胖或超重。显然需要对儿童进行大规模的前瞻性研究，以涵盖更广泛的GERD范围。
