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非酒精性脂肪性肝病患者胃食管反流症状的高发生率与血清甘油三酯和胆固醇水平相关,但与单纯内脏肥胖无关。

High prevalence of gastroesophageal reflux symptoms in patients with non-alcoholic fatty liver disease associated with serum levels of triglyceride and cholesterol but not simple visceral obesity.

机构信息

Department of Gastroenterology, Osaka City University Graduate School of Medicine, Osaka, Japan.

出版信息

Digestion. 2012;86(3):228-37. doi: 10.1159/000341418. Epub 2012 Sep 5.

DOI:10.1159/000341418
PMID:22964626
Abstract

BACKGROUND/AIMS: Visceral obesity is commonly involved in the pathogenesis of gastroesophageal reflux disease (GERD) and non-alcoholic fatty liver disease (NAFLD). However, other characteristic factors different from visceral obesity are associated with the pathogenesis of NAFLD. We investigated the prevalence of GERD symptoms in patients with NAFLD and its associated risk factors.

METHODS

NAFLD (n = 96) and controls (n = 139) were enrolled in this study. GERD symptoms were evaluated by using a frequency scale for the symptoms of GERD.

RESULTS

GERD symptom score and its prevalence rate were higher in the NAFLD group (7.4 ± 0.7, 37%) than those seen in the control groups (4.5 ± 0.4, 20%), which was independent of sex, age, and body mass index (BMI). GERD symptoms were correlated with insulin resistance (r = 0.167, p = 0.011), total cholesterol (T-CHO) (r = 0.138, p = 0.034), triglyceride (TG) (r = 0.178, p = 0.006), or immunoreactive insulin (r = 0.173, p = 0.008) but not BMI (r = 0.089, p = 0.175). GERD symptoms of the NAFLD group were significantly severer in the higher group of T-CHO and TG levels than those in the lower group. Multivariate analysis proved that risk factors related to GERD symptoms were TG (OR 3.96, 95% CI 1.31-11.9) and T-CHO (OR 3.39, 95% CI 1.11-10.3).

CONCLUSION

The severity and prevalence of GERD symptoms in patients with NAFLD were high, which was associated with serum levels of TG and T-CHO but not BMI.

摘要

背景/目的:内脏肥胖通常与胃食管反流病(GERD)和非酒精性脂肪肝(NAFLD)的发病机制有关。然而,与内脏肥胖不同的其他特征性因素也与 NAFLD 的发病机制有关。我们研究了 NAFLD 患者中 GERD 症状的患病率及其相关的危险因素。

方法

本研究纳入了 96 例 NAFLD 患者和 139 例对照组。通过 GERD 症状频率量表评估 GERD 症状。

结果

NAFLD 组的 GERD 症状评分和患病率(7.4 ± 0.7,37%)高于对照组(4.5 ± 0.4,20%),且不受性别、年龄和体重指数(BMI)的影响。GERD 症状与胰岛素抵抗(r = 0.167,p = 0.011)、总胆固醇(T-CHO)(r = 0.138,p = 0.034)、甘油三酯(TG)(r = 0.178,p = 0.006)或免疫反应性胰岛素(r = 0.173,p = 0.008)相关,但与 BMI 无关(r = 0.089,p = 0.175)。与 T-CHO 和 TG 水平较低的 NAFLD 组相比,T-CHO 和 TG 水平较高的 NAFLD 组的 GERD 症状更严重。多变量分析证明,与 GERD 症状相关的危险因素是 TG(OR 3.96,95%CI 1.31-11.9)和 T-CHO(OR 3.39,95%CI 1.11-10.3)。

结论

NAFLD 患者 GERD 症状的严重程度和患病率较高,与血清 TG 和 T-CHO 水平有关,与 BMI 无关。

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