Predictive Factors for Future Onset of Reflux Esophagitis: A Longitudinal Case-control Study Using Health Checkup...

Area of Science:

• Gastroenterology
• Preventive Medicine
• Epidemiology

Background:

• Limited understanding of predictive factors for future reflux esophagitis (RE) onset.
• Previous research primarily focused on cross-sectional risk factors.

Purpose of the Study:

• To investigate the time courses of clinical parameters preceding the onset of RE.
• To identify predictive factors for future RE development using longitudinal data.

Main Methods:

• Longitudinal case-control study using health checkup records from 2004-2014 in Japan.
• Multivariate logistic regression and mixed-effects models for repeated measures analysis.
• Analysis included over 230,000 individuals, with 2066 RE cases and 4132 controls.

Main Results:

• Baseline factors associated with RE: higher BMI, elevated ALT, smoking, acid reflux symptoms, hiatal hernia, and absence of atrophic gastritis.
• RE group showed significantly worse longitudinal trends in BMI, fasting blood sugar, triglycerides, liver enzymes (AST, ALT, GGT), acid reflux symptoms, fullness, and hiatal hernia compared to controls.
• Worsening of lifestyle disease markers observed up to 5 years before RE onset.

Conclusions:

• Reflux esophagitis (RE) onset is preceded by a significant deterioration in clinical parameters linked to lifestyle diseases (obesity, diabetes, hyperlipidemia, fatty liver).
• These findings support the classification of RE as a lifestyle disease.
• Targeted lifestyle guidance for individuals with identified risk factors may help prevent RE onset.