Ko S-H, Baeg M K, Jung H S, Kim P, Choi M-G
Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
Department of Internal Medicine, International St. Mary's Hospital, Catholic Kwandong University College of Medicine, Incheon, South Korea.
Neurogastroenterol Motil. 2017 May;29(5). doi: 10.1111/nmo.13002. Epub 2016 Dec 12.
Erosive reflux disease (ERD) is prevalent in the West, and its incidence is increasing in the East. The differences between the West and East, especially in body composition, have not been investigated thoroughly.
Subjects who underwent esophagogastroduodenoscopy and body composition analysis during health screening were analyzed retrospectively. Russian Caucasians who visited Korea were propensity matched with native Koreans. Endoscopy results were analyzed to identify ERD and gastroesophageal flap valve (GEFV) status. Body composition and laboratory results were compared to identify risk factors for ERD.
32 279 subjects underwent health screening with 1496 Russian Caucasians propensity matched with 1496 Koreans. ERD prevalence was 20.2% for Caucasians and 9.8% for Koreans (P<.001). Caucasians had significantly greater body mass index (BMI) and were more sarcopenic. Significant risk factors for ERD were Caucasian ethnicity (OR 1.629, 95% CI 1.265-2.099, P<.001), male gender (OR 2.374, 95% CI 1.883-2.993, P<.001), greater BMI (OR 1.067, 95% CI 1.041-1.093, P<.001), and abnormal GEFV (OR 2.730, 95% CI 2.194-3.397, P<.001). H. pylori seropositivity (OR 0.614, 95% CI 0.488-0.774, P<.001) and atrophic gastritis (OR 0.547, 95% CI 0.411-0.728, P<.001) were significantly preventive.
CONCLUSIONS & INFERENCES: Caucasian ethnicity is a significant risk factor for ERD. Greater BMI, male gender and abnormal GEFV are associated with ERD, and H. pylori seropositivity and atrophic gastritis are preventive. Further studies are needed to assess the differences in ERD between Caucasians and East Asians.
糜烂性反流病（ERD）在西方较为普遍，在东方其发病率也在上升。东西方之间的差异，尤其是身体成分方面的差异，尚未得到充分研究。
对在健康筛查期间接受了食管胃十二指肠镜检查和身体成分分析的受试者进行回顾性分析。将前往韩国的俄罗斯白种人与韩国本地人进行倾向匹配。分析内镜检查结果以确定ERD和胃食管瓣（GEFV）状态。比较身体成分和实验室检查结果以确定ERD的危险因素。
32279名受试者接受了健康筛查，1496名俄罗斯白种人与1496名韩国人进行了倾向匹配。白种人的ERD患病率为20.2%，韩国人为9.8%（P<0.001）。白种人的体重指数（BMI）显著更高，且肌肉减少症更多见。ERD的显著危险因素为白种人种族（比值比[OR]1.629，95%置信区间[CI]1.265 - 2.099，P<0.001）、男性（OR 2.374，95% CI 1.883 - 2.993，P<0.001）、更高的BMI（OR 1.067，95% CI 1.041 - 1.093，P<0.001）以及异常的GEFV（OR 2.730，95% CI 2.194 - 3.397，P<0.001）。幽门螺杆菌血清阳性（OR 0.614，95% CI 0.488 - 0.774，P<0.001）和萎缩性胃炎（OR 0.547，95% CI 0.411 - 0.728，P<0.001）具有显著的预防作用。
白种人种族是ERD的一个重要危险因素。更高的BMI、男性以及异常的GEFV与ERD相关，而幽门螺杆菌血清阳性和萎缩性胃炎具有预防作用。需要进一步研究以评估白种人和东亚人在ERD方面的差异。
