Department of Internal Medicine and Healthcare Research Institute, Seoul National University Hospital Healthcare System Gangnam Center, Seoul 06236, South Korea.
Department of Anesthesiology and Pain Medicine, Seoul National University College of Medicine, Seoul 03080, South Korea.
World J Gastroenterol. 2022 Feb 28;28(8):853-867. doi: 10.3748/wjg.v28.i8.853.
() infection is known to prevent the occurrence of gastroesophageal reflux disease (GERD) by inducing gastric mucosal atrophy. However, little is known about the relationship between atrophic gastritis (AG) and GERD.
To confirm the inverse correlation between AG and the occurrence and severity of GERD.
Individuals receiving health checkups who underwent upper gastrointestinal endoscopy at Seoul National University Healthcare System Gangnam Center were included. The grade of reflux esophagitis was evaluated according to the Los Angeles classification. Endoscopic AG (EAG) was categorized into six grades. Serologic AG (SAG) was defined as pepsinogen I ≤ 70 ng/mL and pepsinogen I/II ratio ≤ 3.0. The association between the extent of EAG and SAG and the occurrence and severity of GERD was evaluated using multivariate logistic regression analysis.
In total, 4684 individuals with GERD were compared with 21901 healthy controls. In multivariate logistic regression analysis, advanced age, male sex, body mass index > 23 kg/m, presence of metabolic syndrome, current smoking, and alcohol consumption were associated with an increased risk of GERD. Seropositivity for immunoglobulin G antibodies was associated with a decreased risk of GERD. There was an inverse correlation between the extent of EAG and occurrence of GERD: Odds ratio (OR), 1.01 [95% confidence interval (CI): 0.90-1.14] in C1, 0.87 (0.78-0.97) in C2, 0.71 (0.62-0.80) in C3, 0.52 (0.44-0.61) in O1, 0.37 (0.29-0.48) in O2, and 0.28 (0.18-0.43) in O3. Additionally, the extent of EAG showed an inverse correlation with the severity of GERD. The presence of SAG was correlated with a reduced risk of GERD (OR = 0.49, 95%CI: 0.28-0.87, = 0.014).
The extent of EAG and SAG exhibited strong inverse relationships with the occurrence and severity of GERD. AG followed by infection may be independently protect against GERD.
已知幽门螺杆菌感染通过诱导胃黏膜萎缩来预防胃食管反流病（GERD）的发生。然而，关于萎缩性胃炎（AG）与 GERD 之间的关系知之甚少。
确认 AG 与 GERD 的发生和严重程度之间存在负相关关系。
纳入在首尔国立大学保健系统江南中心接受健康检查并接受上消化道内镜检查的个体。根据洛杉矶分类法评估反流性食管炎的严重程度。内镜下 AG（EAG）分为六级。血清学 AG（SAG）定义为胃蛋白酶原 I≤70ng/ml 且胃蛋白酶原 I/II 比值≤3.0。使用多变量逻辑回归分析评估 EAG 和 SAG 的严重程度与 GERD 的发生和严重程度之间的关系。
共比较了 4684 例 GERD 患者和 21901 例健康对照者。多变量逻辑回归分析显示，年龄较大、男性、体重指数（BMI）>23kg/m2、存在代谢综合征、当前吸烟和饮酒与 GERD 风险增加相关。免疫球蛋白 G 抗体血清阳性与 GERD 风险降低相关。EAG 的严重程度与 GERD 的发生呈负相关：C1 为 1.01（95%置信区间[CI]：0.90-1.14），C2 为 0.87（0.78-0.97），C3 为 0.71（0.62-0.80），O1 为 0.52（0.44-0.61），O2 为 0.37（0.29-0.48），O3 为 0.28（0.18-0.43）。此外，EAG 的严重程度与 GERD 的严重程度呈负相关。SAG 的存在与 GERD 风险降低相关（OR=0.49，95%CI：0.28-0.87，P=0.014）。
EAG 和 SAG 的严重程度与 GERD 的发生和严重程度呈强负相关。AG 继发于幽门螺杆菌感染可能独立预防 GERD。
