Kumar Sushil, Sharma Saurabh, Norboo Tsering, Dolma Diskit, Norboo Angchuk, Stobdan Tsering, Rohatgi S, Munot K, Ahuja Vineet, Saraya Anoop
Department of Gastroenterology and Human Nutrition, All India Institute of Medical Sciences, New Delhi 110 029, India.
Indian J Gastroenterol. 2011 May;30(3):135-43. doi: 10.1007/s12664-010-0066-4. Epub 2010 Dec 23.
We did a population-based cross-sectional study to investigate the prevalence and risk factors of gastroesophageal reflux disease (GERD) in a high altitude area.
An observational study using a validated questionnaire consisting of demographic, lifestyle and dietary characteristics was administered in an interview based format by two clinicians on a sample of adult population residing in urban area and rural high altitude areas of Ladakh. Presence of GERD was defined as a score of ≥4 using a previously validated symptom score based on the severity and frequency of heartburn and regurgitation. Other factors studied were body mass index (BMI), oxygen saturation levels by pulse oximetry and serum lipid profile. A multivariate analysis was done to find out risk factors for symptomatic GERD.
Of the 905 subjects analyzed, there were 399 (44.1%) men; 469 (51.8%) were from rural background and 722 (79.8%) lived in areas 3,000 m above sea level. Symptomatic GERD was present in 169 (18.7%) subjects. Regurgitation occurred once a week in 34.8% and heartburn occurred in 42.9% of subjects. Sixteen (9.5%) had moderate-severe disease activity while 153 (90.5%) had mild disease. Three hundred and eighty-eight (42.7%) and 315 (34.8%) subjects had symptom of heartburn and regurgitation (at least once a week), respectively. On multivariate analysis, risk factors for GERD were age ≤50 years (OR: 1.508, 95% CI: 1.028-2.213), sedentary lifestyle (OR: 2.78, 95% CI: 1.016-7.638), lower intake of salt tea (OR: 1.663, 95% CI: 1.014-2.726); whereas the protective factors were no intake of meat (OR: 0.841, 95% CI: 0.715-0.990), intake of fresh fruits ≥1/week (OR: 0.631, 95% CI: 0.409-0.973), and serum LDL ≤150 mg/dL (OR: 0.435, 95% CI: 0.218-0.868).
This population-based study in a high altitude area in India suggests a high prevalence (18.7%) of GERD. A younger age group, sedentary lifestyle, serum LDL >150 mg/dL, high consumption of meat, low consumption of salted tea and low consumption of fresh fruits were significant risk factors for development of GERD.
我们开展了一项基于人群的横断面研究，以调查高海拔地区胃食管反流病（GERD）的患病率及危险因素。
采用一份经过验证的问卷进行观察性研究，问卷内容包括人口统计学、生活方式和饮食特征，由两名临床医生以访谈形式对居住在拉达克城市地区和农村高海拔地区的成年人群样本进行调查。GERD的存在根据先前基于烧心和反流的严重程度及频率验证的症状评分，定义为得分≥4分。研究的其他因素包括体重指数（BMI）、脉搏血氧饱和度水平和血脂谱。进行多变量分析以找出有症状GERD的危险因素。
在分析的905名受试者中，有399名（44.1%）男性；469名（51.8%）来自农村，722名（79.8%）居住在海拔3000米以上地区。169名（18.7%）受试者存在有症状GERD。34.8%的受试者反流每周发生一次，42.9%的受试者有烧心症状。16名（9.5%）有中度至重度疾病活动，153名（90.5%）有轻度疾病。388名（42.7%）和315名（34.8%）受试者分别有烧心和反流症状（至少每周一次）。多变量分析显示，GERD的危险因素为年龄≤50岁（比值比：1.508，95%置信区间：1.028 - 2.213）、久坐的生活方式（比值比：2.78，95%置信区间：1.016 - 7.638）、盐茶摄入量较低（比值比：1.663，95%置信区间：1.014 - 2.726）；而保护因素为不摄入肉类（比值比：0.841，95%置信区间：0.715 - 0.990）、每周摄入新鲜水果≥1次（比值比：0.631，95%置信区间：0.409 - 0.973）以及血清低密度脂蛋白≤150mg/dL（比值比：0.435，9%置信区间：0.218 - 0.868）。
印度高海拔地区的这项基于人群的研究表明GERD患病率较高（18.7%）。年龄较小、久坐的生活方式、血清低密度脂蛋白>150mg/dL、肉类高消费、盐茶低消费和新鲜水果低消费是GERD发生的重要危险因素。
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