Seoul National University Hospital, Healthcare System Gangnam Center, Healthcare Research Institute, Seoul, Korea.
Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
PLoS One. 2019 Jan 7;14(1):e0210490. doi: 10.1371/journal.pone.0210490. eCollection 2019.
Some recent studies suggested that reflux esophagitis is positively correlated with asthma. However, there are debates on this issue. The aim of this study is to clarify the true association between reflux esophagitis and asthma in a large population.
Medical records of subjects who received health surveillance checkup between January 2005 and December 2011 were reviewed. Their endoscopic findings, medical history, body mass index, and smoking history were analyzed. Erosive esophagitis was defined as endoscopically detected mucosal break at the Z-line, irrespective of reflux symptom. Information about asthma history was obtained from their questionnaires and medical records.
Out of the total 15,999 patients, 986 had erosive esophagitis and 376 had asthma. In this population, erosive esophagitis was inversely related with asthma in univariable analysis (OR, 0.586; 95% CI, 0.342-1.003, p = 0.049). In multivariable analysis, asthma was demonstrated as an independent negative risk factor for erosive esophagitis (OR, 0.472; 95% CI, 0.257-0.869, p = 0.016), under adjustment with age (OR, 1.000; 95% CI, 0.994-1.006, p = 0.977), male sex (OR, 2.092; 95% CI, 1.683-2.601, p < 0.001), body mass index (OR, 1.115; 95% CI, 1.090-1.141, p < 0.001), smoking (OR, 1.584; 95% CI, 1.318-1.902, p < 0.001), and urban residence (OR, 1.363; 95% CI, 1.149-1.616, p < 0.001). Likewise, erosive esophagitis was shown to be an independent negative risk factor for asthma (OR, 0.558; 95% CI, 0.324-0.960, p = 0.035) under adjustment with age (OR, 1.025; 95% CI, 1.015-1.034, p <0.001), male sex (OR, 0.861; 95% CI, 0.691-1.074, p = 0.185), and body mass index (OR, 1.067; 95% CI, 1.030-1.106, p < 0.001) in multivariable analysis.
Contrary to previous studies, this large scale data showed inverse association between erosive esophagitis and asthma. Further studies investigating the clear mechanism of this phenomenon are warranted.
一些最近的研究表明，反流性食管炎与哮喘呈正相关。然而，对此问题存在争议。本研究旨在在大人群中阐明反流性食管炎与哮喘之间的真实关联。
回顾了 2005 年 1 月至 2011 年 12 月间接受健康检查的受试者的病历。分析了他们的内镜检查结果、病史、体重指数和吸烟史。糜烂性食管炎定义为内镜下可见 Z 线处的黏膜破裂，无论是否存在反流症状。哮喘病史的信息是从他们的问卷和病历中获得的。
在总共 15999 名患者中，986 名患有糜烂性食管炎，376 名患有哮喘。在该人群中，糜烂性食管炎在单变量分析中与哮喘呈负相关（OR，0.586；95%CI，0.342-1.003，p=0.049）。在多变量分析中，哮喘被证明是糜烂性食管炎的独立负风险因素（OR，0.472；95%CI，0.257-0.869，p=0.016），调整了年龄（OR，1.000；95%CI，0.994-1.006，p=0.977）、男性（OR，2.092；95%CI，1.683-2.601，p<0.001）、体重指数（OR，1.115；95%CI，1.090-1.141，p<0.001）、吸烟（OR，1.584；95%CI，1.318-1.902，p<0.001）和城市居住（OR，1.363；95%CI，1.149-1.616，p<0.001）。同样，糜烂性食管炎也是哮喘的独立负风险因素（OR，0.558；95%CI，0.324-0.960，p=0.035），调整了年龄（OR，1.025；95%CI，1.015-1.034，p<0.001）、男性（OR，0.861；95%CI，0.691-1.074，p=0.185）和体重指数（OR，1.067；95%CI，1.030-1.106，p<0.001）。
与之前的研究相反，这项大规模数据显示糜烂性食管炎与哮喘之间呈负相关。需要进一步研究以阐明这种现象的明确机制。
