Kim Ki Ju, Lee Ban Seok
Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Korea.
Digestive Disease Center, Department of Internal Medicine, Gumi CHA Hospital, Gumi, Korea.
Yonsei Med J. 2017 Jul;58(4):743-748. doi: 10.3349/ymj.2017.58.4.743.
Although central obesity is a risk factor for erosive esophagitis, information regarding the association between central obesity and non-erosive reflux disease (NERD) is still scarce. The purpose of this study was to investigate the risk factors for NERD by comparing NERD patients and healthy controls.
Comprehensive clinical data from 378 patients who underwent esophagogastroduodenoscopy from December 2012 to May 2013 and had no visible esophageal mucosal breakage were analyzed. The Korean version of GerdQ questionnaire was used to diagnose NERD. The association between central obesity and NERD was assessed after matching subjects according to propensity scores.
There were 119 NERD patients and 259 controls. In multivariate analysis, central obesity, female gender, and younger age were significantly associated with NERD [odds ratio (OR)=2.55, 1.93, and 1.80; p=0.001, 0.005, and 0.011, respectively]. After adjusting for 12 clinical variables using propensity score matching, 114 NERD patients were matched to 114 controls. All variables were well balanced between the two groups (average D before matching: 0.248, after matching: 0.066). Patients with NERD were more likely to have central obesity than healthy controls (28.1% vs. 7.9%). After adjusting for propensity scores and all covariates in multivariable logistic regression analyses, central obesity was still found to be a significant risk factor for NERD (OR=4.55, p<0.001).
Central obesity appears to be an independent risk factor for NERD. This result supports the presence of an association between GERD and central obesity, even in the absence of esophageal erosion (NERD).
尽管中心性肥胖是糜烂性食管炎的一个危险因素，但关于中心性肥胖与非糜烂性反流病（NERD）之间关联的信息仍然匮乏。本研究的目的是通过比较NERD患者和健康对照来调查NERD的危险因素。
分析了2012年12月至2013年5月接受食管胃十二指肠镜检查且食管黏膜无可见破损的378例患者的综合临床数据。采用韩语版GerdQ问卷诊断NERD。根据倾向得分匹配受试者后，评估中心性肥胖与NERD之间的关联。
有119例NERD患者和259例对照。在多变量分析中，中心性肥胖、女性性别和较年轻年龄与NERD显著相关[比值比（OR）=2.55、1.93和1.80；p分别为0.001、0.005和0.011]。使用倾向得分匹配调整12个临床变量后，114例NERD患者与114例对照匹配。两组之间所有变量均达到良好平衡（匹配前平均D：0.248，匹配后：0.066）。与健康对照相比，NERD患者更易出现中心性肥胖（28.1%对7.9%）。在多变量逻辑回归分析中调整倾向得分和所有协变量后，仍发现中心性肥胖是NERD的一个显著危险因素（OR=4.55，p<0.001）。
中心性肥胖似乎是NERD的一个独立危险因素。这一结果支持了即使在无食管糜烂（NERD）的情况下，胃食管反流病与中心性肥胖之间也存在关联。
