Yang Hyo-Joon, Chang Yoosoo, Park Soo-Kyung, Jung Yoon Suk, Park Jung Ho, Park Dong Il, Cho Yong Kyun, Ryu Seungho, Sohn Chong Il
Division of Gastroenterology, Department of Internal Medicine and Gastrointestinal Cancer Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 29 Saemunan-ro, Jongno-gu, Seoul, 03181, Korea.
Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
Dig Dis Sci. 2017 Dec;62(12):3605-3613. doi: 10.1007/s10620-017-4805-6. Epub 2017 Oct 23.
Reflux esophagitis is associated with obesity and metabolic syndrome; however, the relationship between nonalcoholic fatty liver disease (NAFLD) and reflux esophagitis is unclear.
We examined the association between NAFLD and the development of reflux esophagitis.
Our cohort consisted of 117,377 Korean adults without reflux esophagitis at baseline who underwent a health checkup program including upper endoscopy between 2002 and 2014 and were followed annually or biennially until December 2014. NAFLD was defined as hepatic steatosis on ultrasonography in the absence of excessive alcohol use or any other identifiable cause.
Over 520,843.2 person-years of follow-up, 22,500 participants developed reflux esophagitis (incidence density, 43.2 per 1000 person-years). In models adjusted for age and sex, the adjusted hazard ratio (aHR) (95% confidence interval [CI]) for incident reflux esophagitis in subjects with NAFLD compared to those without was 1.16 (1.13-1.20). After further adjustment for confounders of center, year of visit, smoking status, alcohol intake, regular exercise, education level, and body mass index, the association between NAFLD and incident reflux esophagitis was attenuated, but remained significant (aHR 1.06; 95% CI 1.02-1.10).
In this large cohort of Korean men and women, participants with NAFLD exhibited increased incidence of reflux esophagitis independent of possible confounders, suggesting that NAFLD contributes to the development of reflux esophagitis.
反流性食管炎与肥胖和代谢综合征相关；然而，非酒精性脂肪性肝病（NAFLD）与反流性食管炎之间的关系尚不清楚。
我们研究了NAFLD与反流性食管炎发生之间的关联。
我们的队列由117377名基线时无反流性食管炎的韩国成年人组成，他们在2002年至2014年间参加了包括上消化道内镜检查在内的健康体检项目，并每年或每两年随访一次，直至2014年12月。NAFLD定义为超声检查显示肝脂肪变性，且无过量饮酒或任何其他可识别的病因。
在超过520843.2人年的随访中，22500名参与者发生了反流性食管炎（发病密度为每1000人年43.2例）。在根据年龄和性别进行调整的模型中，与无NAFLD的受试者相比，有NAFLD的受试者发生反流性食管炎的校正风险比（aHR）（95%置信区间[CI]）为1.16（1.13 - 1.20）。在进一步调整中心、就诊年份、吸烟状况、酒精摄入量、规律运动、教育水平和体重指数等混杂因素后，NAFLD与反流性食管炎发病之间的关联减弱，但仍具有统计学意义（aHR 1.06；95% CI 1.02 - 1.10）。
在这个由大量韩国男性和女性组成的队列中，患有NAFLD的参与者反流性食管炎发病率增加，且独立于可能的混杂因素，这表明NAFLD促成了反流性食管炎的发生。
