Chang Chung-Hsin, Wu Cheng-Pin, Wang Jung-Der, Lee Shou-Wu, Chang Chi-Sen, Yeh Hong-Zen, Ko Chung-Wang, Lien Han-Chung
Division of Gastroenterology, Taichung Veterans General Hospital, Taichung, Taiwan.
Health Examination Center, China Medical University Hospital, Taichung, Taiwan.
PLoS One. 2017 Mar 6;12(3):e0173230. doi: 10.1371/journal.pone.0173230. eCollection 2017.
Asymptomatic erosive esophagitis (AEE) is commonly found in men, and might be a risk factor of developing esophageal adenocarcinoma. We aimed to determine if specific dietary habits increase the risk of AEE in asymptomatic Taiwanese men.
We recruited male adults undergoing upper gastrointestinal endoscopy for health check. We excluded subjects with reflux symptoms, or taking anti-reflux medications or drugs that potentially impair lower esophageal sphincter function or cause mucosal injury. The frequency of consuming reflux-provoking diets including alcohol, tea, coffee, tomato/citric juice, chocolate, sweet food, and spicy food was assessed. The erosive esophagitis was diagnosed based on the Los Angeles Classification after endoscopy. Frequent consumption of a specific diet was defined as ≥4 days/week of consuming that diet.
A total of 1256 participants were recruited. After excluding 424 ineligible subjects, AEE was identified in 180 (22%) among 832 asymptomatic subjects. The risk of AEE increased with the number of days per week of consuming alcohol or tea: nondrinkers (19%, 17%), occasional drinkers (<1 day/week; 19%, 15%), regular drinkers (1-3 days/week; 26%, 21%), frequent drinkers (4-6 days/week; 32%, 22%), and daily drinkers (42%, 28%), respectively (trend test P < 0.001 for both). Multivariate analysis showed that hiatus hernia (adjusted odds ratio (aOR) 5.0, 95% confidence interval (CI) 2.6-9.6), drinking alcohol ≥4 days/week (aOR 2.3, 95% CI 1.3-4.0), and drinking tea ≥4 days/week (aOR 1.6, 95% CI 1.1-2.3) are independent risk factors of AEE. The risk of AEE was 3.8 times greater for those drinking both alcohol and tea ≥4 days/week than the non-drinkers.
Frequent alcohol and tea consumption increased the risk of AEE in Taiwanese men.
无症状性糜烂性食管炎(AEE)在男性中较为常见,可能是食管腺癌发生的危险因素。我们旨在确定特定饮食习惯是否会增加无症状台湾男性患AEE的风险。
我们招募接受上消化道内镜检查以进行健康检查的成年男性。我们排除了有反流症状、正在服用抗反流药物或可能损害食管下括约肌功能或导致黏膜损伤的药物的受试者。评估食用包括酒精、茶、咖啡、番茄/柑橘汁、巧克力、甜食和辛辣食物在内的易引发反流饮食的频率。内镜检查后根据洛杉矶分类法诊断糜烂性食管炎。经常食用特定饮食定义为每周食用该饮食≥4天。
共招募了1256名参与者。排除424名不符合条件的受试者后,832名无症状受试者中有180名(22%)被诊断为AEE。AEE的风险随着每周饮酒或饮茶天数的增加而增加:不饮酒者(19%,17%)、偶尔饮酒者(每周<1天;19%,15%)、经常饮酒者(每周1 - 3天;26%,21%)、频繁饮酒者(每周4 - 6天;32%,22%)和每日饮酒者(42%,28%),两者的趋势检验P均<0.001。多变量分析显示,食管裂孔疝(调整后的优势比(aOR)5.0,95%置信区间(CI)2.6 - 9.6)、每周饮酒≥4天(aOR 2.3,95% CI 1.3 - 4.0)和每周饮茶≥4天(aOR 1.6,95% CI 1.1 - 2.3)是AEE的独立危险因素。每周饮酒和饮茶均≥4天的人患AEE的风险是不饮酒者的3.8倍。
经常饮酒和饮茶会增加台湾男性患AEE的风险。