Department of Otorhinolaryngology-Head & Neck Surgery, CHA Bundang Medical Center, CHA University, Seongnam, Korea.
Hallym Data Science Laboratory, Hallym University College of Medicine, Anyang, Korea.
Clin Rheumatol. 2021 Apr;40(4):1249-1257. doi: 10.1007/s10067-020-05400-0. Epub 2020 Sep 17.
Several previous studies have suggested a relationship between GERD and RA. However, no study has investigated the bidirectional relationship between GERD and RA. This study aimed to evaluate the causal relationships between rheumatoid arthritis (RA) and gastroesophageal reflux disease (GERD). Participants aged ≥ 20 years old in the Korean Health Insurance Review and Assessment Service-National Sample Cohort from 2002 to 2013 were enrolled. In study I, 132,140 GERD participants were 1:2 matched with 264,280 control I participants. In study II, 6615 RA participants were 1:4 matched with 26,460 control II participants. Both control I and control II groups were matched with their study groups for age, sex, income, and region of residence. The occurrence of RA (study I) and GERD (study II) were followed up in both the study and control groups. The hazard ratios (HRs) of GERD for RA (study I) and of RA for GERD (study II) were analysed using stratified Cox-proportional hazards models. In study I, 0.8% (1,034/132,140) of the GERD group and 0.5% (1,290/264,280) of the control I group had RA (P < 0.001). The GERD group demonstrated a 1.49-fold higher adjusted HR than did the control I group (95% confidence interval (95% CI) = 1.37-1.62, P < 0.001). In study II, 22.5% (1,490/6,615) of the RA group and 15.2% (4,034/26,460) of the control II group had GERD (P < 0.001). The RA group showed a 1.46-fold higher adjusted HR than did the control II group (95% CI = 1.38-1.55, P < 0.001). GERD and RA have bidirectional associations in Korean adult population. Key Points • Several previous studies have suggested a relationship between gastroesophageal reflux disease (GERD) and rheumatoid arthritis (RA). • However, no study has investigated the bidirectional relationship between GERD and RA. • This is the first study to present a bidirectional relationship between GERD and RA. • GERD and RA have bidirectional relations with each other.
几项先前的研究表明胃食管反流病（GERD）与类风湿关节炎（RA）之间存在关系。然而，尚无研究调查 GERD 和 RA 之间的双向关系。本研究旨在评估类风湿关节炎（RA）和胃食管反流病（GERD）之间的因果关系。纳入了 2002 年至 2013 年期间韩国健康保险审查和评估服务-国家样本队列中年龄≥20 岁的参与者。在研究 I 中，将 132140 例 GERD 参与者与 264280 例对照 I 参与者按 1:2 匹配。在研究 II 中，将 6615 例 RA 参与者与 26460 例对照 II 参与者按 1:4 匹配。对照 I 和对照 II 组均与各自的研究组按年龄、性别、收入和居住地进行匹配。对研究组和对照组均进行 RA（研究 I）和 GERD（研究 II）的发病情况随访。使用分层 Cox 比例风险模型分析 GERD 发生 RA（研究 I）和 RA 发生 GERD（研究 II）的风险比（HR）。在研究 I 中，GERD 组的 0.8%（1034/132140）和对照 I 组的 0.5%（1290/264280）发生 RA（P<0.001）。GERD 组的调整 HR 是对照 I 组的 1.49 倍（95%置信区间[95%CI]：1.37-1.62，P<0.001）。在研究 II 中，RA 组的 22.5%（1490/6615）和对照 II 组的 15.2%（4034/26460）发生 GERD（P<0.001）。RA 组的调整 HR 是对照 II 组的 1.46 倍（95%CI：1.38-1.55，P<0.001）。在韩国成年人群中，GERD 和 RA 之间存在双向关联。要点 • 几项先前的研究表明胃食管反流病（GERD）与类风湿关节炎（RA）之间存在关系。 • 然而，尚无研究调查 GERD 和 RA 之间的双向关系。 • 本研究首次提出 GERD 和 RA 之间存在双向关系。 • GERD 和 RA 之间存在双向关系。
