Peng Lei, Li Xueqin, Qi Jinfeng, Shan Yangang, Zhang Liming, Yang Zhenqing, Wu Xucheng, Agogo George O, Liu Zuyun, Mao Genxiang, Wu Honglei
Department of Gastroenterology, The Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan, 250033, Shandong, China.
Center for Clinical Big Data and Analytics of the Second Affiliated Hospital, and Department of Big Data in Health Science School of Public Health, the Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou, 310058, Zhejiang, China.
Sci Rep. 2025 Mar 14;15(1):8916. doi: 10.1038/s41598-025-93114-1.
To investigate the prospective association of frailty status, especially the early stage, with the long-term risk of Gastroesophageal reflux disease (GERD) in a large prospective cohort. We included participants who were free of GERD and cancer at baseline and use of aspirin and non-steroidal anti-inflammatory drugs (NSAIDs) from the UK Biobank (UKB). Frailty status was assessed using Fried phenotype including five items (weight loss, exhaustion, low grip strength, low physical activity, slow walking pace) and classified as non-frail, pre-frail, and frail. The outcome was incident GERD. The frailty status was assessed using Cox proportional hazard model. Among 327,965 participants (mean age 56.6 years) at baseline, 151,689 (46.3%) were pre-frail and 14,288 (4.4%) were frail. During a median of 13.5-years of follow-up, 31,027 (9.5%) participants developed GERD. Compared with non-frail participants, pre-frail (hazard ratios [HR] = 1.21, 95% confidence interval [CI] 1.18-1.24) and frail (HR = 1.60, 95% CI 1.52-1.68) participants had significantly higher risks of GERD. Among the five indicators of frailty, exhaustion demonstrated the strongest association with the risk of GERD (HR = 1.42, 95% CI 1.38-1.47). Subgroup analysis showed strong associations among younger (< 60 years), female, high-educated, unemployed participants, and those who had BMI < 18.5 kg/m (all P for interaction < 0.05). Frailty, especially pre-frail, which is potentially reversible, was associated with higher risk of GERD in middle-aged and older individuals. The findings underscore the importance of integrating routine frailty assessments and interventions, especially at the early stage, to improve digestive health.
在一个大型前瞻性队列中，研究虚弱状态尤其是早期虚弱状态与胃食管反流病（GERD）长期风险之间的前瞻性关联。我们纳入了英国生物银行（UKB）中基线时无GERD和癌症且未使用阿司匹林及非甾体抗炎药（NSAIDs）的参与者。使用Fried表型评估虚弱状态，该表型包括五个项目（体重减轻、疲惫、握力低、身体活动少、步行速度慢），并分为非虚弱、虚弱前期和虚弱。结局为新发GERD。使用Cox比例风险模型评估虚弱状态。在基线时的327,965名参与者（平均年龄56.6岁）中，151,689名（46.3%）为虚弱前期，14,288名（4.4%）为虚弱。在中位13.5年的随访期间，31,027名（9.5%）参与者发生了GERD。与非虚弱参与者相比，虚弱前期（风险比[HR]=1.21，95%置信区间[CI]1.18 - 1.24）和虚弱（HR=1.60，95%CI 1.52 - 1.68）参与者发生GERD的风险显著更高。在虚弱的五个指标中，疲惫与GERD风险的关联最强（HR=1.42，95%CI 1.38 - 1.47）。亚组分析显示，在年龄较小（<60岁）、女性、高学历、未就业的参与者以及体重指数（BMI）<18.5 kg/m的参与者中存在强关联（所有交互作用P<0.05）。虚弱，尤其是可能可逆的虚弱前期，与中老年个体GERD的较高风险相关。这些发现强调了整合常规虚弱评估和干预措施的重要性，尤其是在早期阶段，以改善消化健康。
