Department of Gastroenterology, The First Affiliated Hospital of Dalian Medical University, Dalian, 116011, China.
Dalian Central Laboratory of Integrative Neuro-gastrointestinal Dynamics and Metabolism Related Diseases Prevention and Treatment, Dalian, 116011, China.
BMC Endocr Disord. 2024 Nov 7;24(1):239. doi: 10.1186/s12902-024-01771-6.
Obesity is associated with an increased risk of reflux esophagitis (RE). Metabolic abnormalities have been implicated in the pathogenesis of RE. However, the role of metabolic status in the risk of RE among individuals with varying degrees of obesity remains unclear. Therefore, our study aimed to assess the association between metabolic obesity phenotypes and the risk of RE.
This study included a cohort of 24,368 participants aged 18 years and older who underwent upper gastrointestinal endoscopy at the First Affiliated Hospital of Dalian Medical University during health checkups between January 1, 2008, and December 31, 2021. Among these participants, a total of 9,947 individuals were classified into four groups based on their obesity phenotype: metabolically healthy normal weight (MHNW), metabolically healthy obesity (MHO), metabolically unhealthy normal weight (MUNW), and metabolically unhealthy obesity (MUO). To account for potential confounding factors, multivariate logistic regression analysis was applied to examine the association between metabolic obesity phenotypes and the risk of RE, with stratification by sex and age.
Among all participants, the MUNW, MHO, and MUO groups demonstrated a higher risk of RE when compared to the MHNW group. After controlling for all confounding factors, the MUO group exhibited the highest risk, with an odds ratio (OR) of 3.723 (95% CI: 2.751-5.040) in males and 5.482 (95% CI: 4.080-7.367) in females. The prevalence of RE increased in proportion to the number of metabolic risk factors. Subgroup analyses, which accounted for all confounders, revealed that the MHO, MUNW, and MUO phenotypes were associated with an elevated risk of RE in individuals under 60 years old as well as those over 60 years old. Interestingly, a more comprehensive analysis indicated that obesity may have a greater effect on the risk of RE than metabolic disorders.
Both metabolic disorders and obesity were associated with an increased risk of RE. The effect of obesity on RE prevalence may be stronger than that of metabolic disorders, emphasizing the significance of obesity regardless of metabolic health status. Clinical interventions should address not only obesity but also metabolic disorders in order to reduce the risk of RE.
肥胖与反流性食管炎（RE）的风险增加有关。代谢异常与 RE 的发病机制有关。然而，在不同程度肥胖的个体中，代谢状态与 RE 风险之间的关系尚不清楚。因此，我们的研究旨在评估代谢性肥胖表型与 RE 风险之间的关系。
本研究纳入了 2008 年 1 月 1 日至 2021 年 12 月 31 日在大连医科大学第一附属医院进行健康检查的年龄在 18 岁及以上的 24368 名参与者。其中，共有 9947 名参与者根据其肥胖表型分为 4 组：代谢健康正常体重（MHNW）、代谢健康肥胖（MHO）、代谢不健康正常体重（MUNW）和代谢不健康肥胖（MUO）。为了考虑潜在的混杂因素，我们应用多变量逻辑回归分析来检验代谢性肥胖表型与 RE 风险之间的关系，并按性别和年龄进行分层。
在所有参与者中，与 MHNW 组相比，MUNW、MHO 和 MUO 组的 RE 风险更高。在控制所有混杂因素后，MUO 组的风险最高，男性的比值比（OR）为 3.723（95%CI：2.751-5.040），女性为 5.482（95%CI：4.080-7.367）。RE 的患病率随着代谢危险因素数量的增加而增加。在考虑了所有混杂因素的亚组分析中，我们发现 MHO、MUNW 和 MUO 表型与 60 岁以下和 60 岁以上人群的 RE 风险增加有关。有趣的是，更全面的分析表明，肥胖对 RE 风险的影响可能大于代谢紊乱。
代谢紊乱和肥胖均与 RE 风险增加有关。肥胖对 RE 患病率的影响可能强于代谢紊乱，这强调了无论代谢健康状况如何，肥胖的重要性。临床干预措施不仅应针对肥胖，还应针对代谢紊乱，以降低 RE 风险。
