Lee Shou-Wu, Lien Han-Chung, Chang Chi-Sen, Lee Teng-Yu, Peng Yen-Chun, Yeh Hong-Zen
Division of Gastroenterology, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan, ROC; Department of Internal Medicine, Chung Shan Medical University, Taichung, Taiwan, ROC.
Division of Gastroenterology, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan, ROC; Department of Internal Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan, ROC.
J Chin Med Assoc. 2017 Jan;80(1):15-18. doi: 10.1016/j.jcma.2016.08.007. Epub 2016 Oct 15.
Metabolic syndrome has been highlighted as a risk factor for several gastrointestinal diseases, including gastroesophageal reflux disease and Barrett's esophagus (BE). The aim of this study was to investigate the association of metabolic syndrome with erosive esophagitis (EE) and BE.
Data were retrospectively collected from patients who visited the Medical Screening Center at Taichung Veterans General Hospital, Taichung, Taiwan from January 2006 to December 2009. All patients underwent an open-access transoral upper gastrointestinal endoscopy, and serum laboratory data were collected. The exclusion criteria included prior gastric surgery, or presence of esophageal varices or peptic ulcers. These patients were assigned to groups according to their endoscopic findings as follows: (1) normal group; (2) EE group; and (3) BE group. Metabolic syndrome was diagnosed based on the International Diabetes Federation criteria.
There were 560/6499 (8.6%) patients, 214/1118 (9.6%) patients, and 19/95 (20%) patients with metabolic syndrome in the normal, EE, and BE groups, respectively. There was a significantly higher percentage of cases with hypertriglyceridemia in the EE group (67%) compared with the other groups. The BE group had significantly higher rates of central obesity (33%) and hypertension (29.5%) compared with rates in the normal and EE groups. After adjusting for confounders, the positive association with metabolic syndrome still existed in both the EE group (adjusted odds ratio=2.43; 95% confidence interval=1.02-3.44) and the BE group (adjusted odds ratio=2.82; 95% confidence interval=2.05-3.88).
Our research indicated that in fact there is a greater risk of concurrent metabolic syndrome in patients with EE or BE.
代谢综合征已被视为包括胃食管反流病和巴雷特食管（BE）在内的多种胃肠道疾病的危险因素。本研究旨在探讨代谢综合征与糜烂性食管炎（EE）和BE之间的关联。
回顾性收集2006年1月至2009年12月期间在台湾台中荣民总医院医学筛查中心就诊患者的数据。所有患者均接受了开放式经口上消化道内镜检查，并收集了血清实验室数据。排除标准包括既往胃部手术史、食管静脉曲张或消化性溃疡。这些患者根据内镜检查结果分为以下几组：（1）正常组；（2）EE组；（3）BE组。代谢综合征根据国际糖尿病联盟标准进行诊断。
正常组、EE组和BE组中患有代谢综合征的患者分别有560/6499（8.6%）、214/1118（9.6%）和19/95（20%）。与其他组相比，EE组中高甘油三酯血症病例的百分比显著更高（67%）。与正常组和EE组相比，BE组的中心性肥胖率（33%）和高血压率（29.5%）显著更高。在对混杂因素进行调整后，EE组（调整后的优势比=2.43；95%置信区间=1.02-3.44）和BE组（调整后的优势比=2.82；95%置信区间=2.05-3.88）与代谢综合征的正相关仍然存在。
我们的研究表明，事实上EE或BE患者并发代谢综合征的风险更高。
