Department of Internal Medicine, Ewha Womans University School of Medicine, Seoul, Korea.
J Korean Med Sci. 2019 Jun 2;34(21):e158. doi: 10.3346/jkms.2019.34.e158.
Gender-related factors might play an important role in the development of reflux esophagitis (RE) and symptomatic gastro-esophageal reflux disease (GERD). We aimed to evaluate the prevalence and risk factors for RE and symptomatic GERD and determine whether gender specific differences exist.
This study was conducted on a health cohort consisting of 10,158 participants who underwent comprehensive health screening. Lifestyles and gastrointestinal symptoms were investigated using a self-reported structured questionnaire. Questionnaires about menstrual status were added for the women.
The prevalence of RE in men was significantly higher than that in women (10.6% vs. 2.0%, < 0.001); however, symptomatic GERD showed predominance in women (6.2% vs. 2.5%, < 0.001). Although the prevalence of RE gradually increased with the duration of menopause stratified by decade ( = 0.007), that of symptomatic GERD rapidly increased across the menopausal transit in women. Apart from common risk factors of obesity and current smoking for RE, over 70 years of age in women and hiatal hernia and hypertriglyceridemia in men were significant risk factors. In symptomatic GERD, high somatization was a common risk factor. Excessive alcohol drinking was a significant risk factor in men, but not in women.
This study showed a predominance of RE in men, but a predominance of symptomatic GERD in women. In women, dynamic increase in the prevalence of GERD is closely related to the menopause conditions and its duration. There are specific risk factors for RE and symptomatic GERD according to gender differences.
性别相关因素可能在反流性食管炎（RE）和有症状的胃食管反流病（GERD）的发展中起重要作用。我们旨在评估 RE 和有症状的 GERD 的患病率和危险因素，并确定是否存在性别特异性差异。
本研究在一个由 10158 名接受全面健康筛查的参与者组成的健康队列中进行。使用自我报告的结构化问卷调查生活方式和胃肠道症状。为女性增加了关于月经状况的问卷。
男性的 RE 患病率明显高于女性（10.6%对 2.0%，<0.001）；然而，女性有症状的 GERD 更为常见（6.2%对 2.5%，<0.001）。尽管在绝经十年期间，RE 的患病率随着绝经的持续时间逐渐增加（=0.007），但女性在绝经过渡期间，有症状的 GERD 患病率迅速增加。除肥胖和当前吸烟等常见 RE 危险因素外，女性年龄超过 70 岁以及男性食管裂孔疝和高甘油三酯血症是显著的危险因素。在有症状的 GERD 中，高躯体化是一个常见的危险因素。过量饮酒是男性的一个显著危险因素，但不是女性。
本研究表明男性 RE 更为常见，但女性有症状的 GERD 更为常见。在女性中，GERD 的患病率动态增加与绝经状况及其持续时间密切相关。根据性别差异，RE 和有症状的 GERD 有特定的危险因素。
