Kim So Young, Min Chanyang, Oh Dong Jun, Choi Hyo Geun
Department of Otorhinolaryngology, Head and Neck Surgery, CHA Bundang Medical Center, CHA University, Seongnam, Republic of Korea.
Hallym Data Science Laboratory, Hallym University College of Medicine, Anyang, Republic of Korea; Graduate School of Public Health, Seoul National University, Seoul, Republic of Korea.
J Allergy Clin Immunol Pract. 2020 Mar;8(3):1005-1013.e9. doi: 10.1016/j.jaip.2019.10.043. Epub 2019 Nov 13.
A relation between gastroesophageal reflux disease (GERD) and asthma has been suggested; however, causality has not been investigated.
This study aimed to delineate the causal relation between GERD and asthma.
Participants of the Korean National Health Insurance Service-National Sample Cohort 2002-2013 who were ≥20 years old were selected for this study. In study I, 116,502 patients with GERD were matched in a 1:2 ratio to 233,004 control I participants, and the hazard ratio (HR) of asthma in patients with GERD was analyzed. In study II, 104,146 patients with asthma were matched in a 1:1 ratio to 104,146 control II participants, and the HR for GERD in patients with asthma was analyzed. A stratified Cox-proportional hazards model was used. Subgroup analyses were performed according to age and sex.
In study I, 12.5% (14,595 of 116,502) of the GERD group and 7.8% (18,135 of 233,004) of the control I group presented asthma (P < .001). The GERD group demonstrated a 1.46-fold higher HR for asthma than the control I group (95% confidence interval [CI] = 1.42-1.49, P < .001). In study II, 16.9% (17,582 of 104,146) of the asthma group and 11.9% (12,393 of 104,146) of the control II group presented GERD (P < .001). The asthma group showed a 1.36-fold higher HR for GERD than the control II group (95% CI = 1.33-1.39, P < .001). All age and sex subgroups presented consistent results.
GERD and asthma had a bidirectional relation in the study population.
已有研究表明胃食管反流病（GERD）与哮喘之间存在关联；然而，因果关系尚未得到研究。
本研究旨在阐明GERD与哮喘之间的因果关系。
本研究选取了韩国国民健康保险服务-全国样本队列2002 - 2013年中年龄≥20岁的参与者。在研究I中，116502例GERD患者与233004例对照I参与者按1:2的比例进行匹配，并分析GERD患者患哮喘的风险比（HR）。在研究II中，104146例哮喘患者与104146例对照II参与者按1:1的比例进行匹配，并分析哮喘患者患GERD的HR。采用分层Cox比例风险模型。根据年龄和性别进行亚组分析。
在研究I中，GERD组中有12.5%（116502例中的14595例）出现哮喘，对照I组中有7.8%（233004例中的18135例）出现哮喘（P <.001）。GERD组患哮喘的HR比对照I组高1.46倍（95%置信区间[CI]=1.42 - 1.49，P <.001）。在研究II中，哮喘组中有16.9%（104146例中的17582例）出现GERD，对照II组中有11.9%（104146例中的12393例）出现GERD（P <.001）。哮喘组患GERD的HR比对照II组高1.
