Crews Nicholas R, Johnson Michele L, Schleck Cathy D, Enders Felicity T, Wongkeesong Louis-Michel, Wang Kenneth K, Katzka David A, Iyer Prasad G
Division of Internal Medicine, Mayo Clinic, Rochester, MN, USA.
Barrett's Esophagus Unit, Division of Gastroenterology and Hepatology, Mayo Clinic, 200 1st St SW, Rochester, MN, 55905, USA.
Dig Dis Sci. 2016 Nov;61(11):3221-3228. doi: 10.1007/s10620-016-4266-3. Epub 2016 Aug 10.
Predictors of erosive esophagitis (EE) and Barrett's esophagus (BE) and the influence of number of risk factors in the community are not well defined.
Rates of BE and EE among community residents identified in a randomized screening trial were defined. The risk of EE and BE associated with single and multiple risk factors (gender, age, GERD, Caucasian ethnicity, ever tobacco use, excess alcohol use, family history of BE or EAC, and central obesity) was analyzed.
Sixty-eight (33 %) of 205 subjects had EE and/or BE. BE prevalence was 7.8 % with dysplasia present in 1.5 %. Rates were comparable between subjects with and without GERD. Male sex and central obesity were independent risk factors. The odds of EE or BE were 3.7 times higher in subjects with three or four risk factors and 5.7 times higher in subjects with five or more risk factors compared with those with two or less factors.
EE and BE are prevalent in the community regardless of the presence of GERD. Risk appeared to be additive, increasing substantially with three or more risk factors.
糜烂性食管炎(EE)和巴雷特食管(BE)的预测因素以及社区中危险因素数量的影响尚未明确界定。
确定在一项随机筛查试验中识别出的社区居民中BE和EE的发生率。分析了与单一和多个危险因素(性别、年龄、胃食管反流病、白种人种族、曾经吸烟、过量饮酒、BE或食管腺癌家族史以及中心性肥胖)相关的EE和BE风险。
205名受试者中有68名(33%)患有EE和/或BE。BE患病率为7.8%,其中发育异常的比例为1.5%。有胃食管反流病和无胃食管反流病的受试者之间的发病率相当。男性和中心性肥胖是独立的危险因素。与有两个或更少危险因素的受试者相比,有三个或四个危险因素的受试者发生EE或BE的几率高3.7倍,有五个或更多危险因素的受试者发生EE或BE的几率高5.7倍。
无论是否存在胃食管反流病,EE和BE在社区中都很普遍。风险似乎具有累加性,随着三个或更多危险因素的出现而大幅增加。