Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden.
National Perinatal Epidemiology and Statistics Unit, Centre for Big Data Research in Health & School of Women's and Children's Health, UNSW, Sydney, Australia.
Clin Exp Allergy. 2022 Jul;52(7):868-877. doi: 10.1111/cea.14106. Epub 2022 Feb 16.
Gastro-oesophageal reflux disease (GERD) is the most common non-allergic comorbidity in adults with asthma; however, comorbidity with other atopic diseases such as eczema and hay fever is unclear. The objective was to assess the comorbidity of GERD with asthma and atopic diseases and to investigate possible mechanisms, including genetic and/or affective factors.
A co-twin control study harnessing 46 583 adult twins. Questionnaires on health status were linked to national patient and prescribed drug register data. Analyses tested associations of comorbidity between multiple definitions of atopic diseases (self-report and register-based) with GERD. Comparisons were made between unpaired, monozygotic (MZ) and dizygotic (DZ) twins to assess genetic liability. Affective traits (depression, anxiety and neuroticism) were added to models as possible explanatory factors.
The risk of GERD in those with asthma was OR (odds ratio) 1.52 (95% CI 1.38, 1.68), hay fever OR 1.22 (95%CI 1.12, 1.34) and eczema OR 1.23 (95%CI 1.10, 1.38). Adjusting for affective traits completely attenuated the comorbidity associations for hay fever and eczema with GERD, and partly for asthma with GERD. Co-twin control associations attenuated suggesting a shared cause for both GERD and atopic diseases. For example, all twins adjOR 1.32 (95%CI 1.00, 1.74), 0.97 (95% CI 0.76-1.23) and 1.11 (95%CI 0.85-1.45) for self-report asthma, hay fever and eczema with GERD respectively.
GERD is a common comorbidity in adults with asthma, hay fever and/or eczema. We found evidence for shared mechanisms suggesting common underlying causes that may involve affective traits requiring further investigation.
胃食管反流病（GERD）是成人哮喘中最常见的非过敏性合并症；然而，与其他特应性疾病（如湿疹和花粉热）的合并症尚不清楚。目的是评估 GERD 与哮喘和特应性疾病的合并症，并探讨可能的机制，包括遗传和/或情感因素。
一项利用 46583 对成年双胞胎的同卵双胞胎对照研究。健康状况问卷与国家患者和处方药物登记数据相关联。分析测试了多种特应性疾病（自我报告和登记）与 GERD 之间的合并症关联。在未配对、同卵（MZ）和异卵（DZ）双胞胎之间进行比较，以评估遗传易感性。将情感特征（抑郁、焦虑和神经质）添加到模型中作为可能的解释因素。
哮喘患者患 GERD 的风险为 OR（比值比）1.52（95%CI 1.38,1.68），花粉热为 OR 1.22（95%CI 1.12,1.34），湿疹为 OR 1.23（95%CI 1.10,1.38）。调整情感特征后，完全减弱了 GERD 与花粉热和湿疹的合并症关联，部分减弱了哮喘与 GERD 的关联。同卵双胞胎对照关联减弱，表明 GERD 和特应性疾病有共同的原因。例如，所有双胞胎的调整后 OR 分别为 1.32（95%CI 1.00,1.74）、0.97（95%CI 0.76-1.23）和 1.11（95%CI 0.85-1.45），用于自我报告的哮喘、花粉热和湿疹与 GERD。
GERD 是成人哮喘、花粉热和/或湿疹的常见合并症。我们发现了共同机制的证据，表明存在共同的潜在原因，可能涉及需要进一步研究的情感特征。
