Yang Hyo-Joon, Chang Yoosoo, Park Soo-Kyung, Jung Yoon Suk, Park Jung Ho, Park Dong Il, Ryu Seungho, Sohn Chong Il
Division of Gastroenterology, Department of Internal Medicine and Gastrointestinal Cancer Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, 03181, Korea.
Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, 04514, Korea.
J Clin Med. 2019 Jan 9;8(1):67. doi: 10.3390/jcm8010067.
We examined the association of abdominal obesity and waist circumference within normal range with the incidence of reflux esophagitis, separately in men and women. This cohort study involved 142,679 Korean adults without reflux esophagitis, who underwent upper endoscopy at baseline and during follow-up. Waist circumference was categorized into the following quartiles: <80, 80.1⁻85, 85.1⁻90, and ≥90.1 cm in men; and <69.3, 69.3⁻74, 74.1⁻79.5, and ≥79.6 cm in women. During the 551,877.8 person-years of follow-up, 29,509 participants developed reflux esophagitis. The association between waist circumference quartiles and risk of reflux esophagitis significantly differed with sex ( for interaction < 0.001). In men, multivariable-adjusted hazard ratios (HRs) (95% confidence intervals (CIs)) comparing waist circumference quartiles 2, 3, and 4 to the lowest quartile were 1.03 (0.99⁻1.07), 1.08 (1.04⁻1.12), and 1.15 (1.10⁻1.19), respectively. In women, HRs (95% CIs) comparing quartiles 1, 2, and 4 to the 3rd quartile were 1.10 (1.04⁻1.17), 1.03 (0.98⁻1.10), and 1.07 (1.01⁻1.13), respectively. In this large cohort with endoscopic follow-up, the risk of reflux esophagitis increased with increasing waist circumference even within the normal range in men, whereas the risk increased with low normal waist circumference or with abdominal obesity in women, indicating a U-shaped association.
我们分别在男性和女性中研究了腹型肥胖以及腰围在正常范围内与反流性食管炎发病率之间的关联。这项队列研究纳入了142,679名无反流性食管炎的韩国成年人，他们在基线期和随访期间接受了上消化道内镜检查。男性腰围被分为以下四分位数：<80、80.1⁻85、85.1⁻90和≥90.1厘米；女性腰围被分为：<69.3、69.3⁻74、74.1⁻79.5和≥79.6厘米。在551,877.8人年的随访期间，29,509名参与者患上了反流性食管炎。腰围四分位数与反流性食管炎风险之间的关联在性别上存在显著差异（交互作用P<0.001）。在男性中，与最低四分位数相比，多变量调整后的危险比（HR）（95%置信区间（CI））在腰围四分位数2、3和4分别为1.03（0.99⁻1.07）、1.08（1.04⁻1.12）和1.15（1.10⁻1.19）。在女性中，与第三四分位数相比，HR（95%CI）在四分位数1、2和4分别为1.10（1.04⁻1.17）、1.03（0.98⁻1.10）和1.07（1.01⁻1.13）。在这个进行内镜随访的大型队列中，即使在男性正常范围内，反流性食管炎的风险也随着腰围增加而升高，而在女性中，正常低腰围或腹型肥胖时风险增加，表明呈U形关联。
