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La obesidad y el estrógeno como factores de riesgo para los síntomas de reflujo gastroesofágico
Magnus Nilsson1, Roar Johnsen, Weimin Ye
1Department of Surgery, Karolinska Institutet, Karolinska Hospital, Stockholm, Sweden. magnus.nilsson@ks.se
JAMA
|July 3, 2003
Resumen
La obesidad aumenta significativamente el riesgo de reflujo gastroesofágico, especialmente en las mujeres. Esta asociación es más fuerte en mujeres premenopáusicas e influenciada por la terapia hormonal, lo que sugiere un papel de los estrógenos en el desarrollo de la enfermedad de reflujo.
Área de la Ciencia:
- Gastroenterología y Gastroenterología.
- Epidemiología La epidemiología.
- Endocrinología Endocrinología.
Sus antecedentes:
- El reflujo gastroesofágico y la obesidad son crecientes preocupaciones de salud pública.
- La evidencia existente que vincula la obesidad y el reflujo es inconsistente.
- Se han sugerido diferencias basadas en el sexo en esta asociación.
Objetivo del estudio:
- Para investigar la relación entre la masa corporal y los síntomas de reflujo gastroesofágico.
- Para determinar la influencia de las hormonas sexuales femeninas en esta asociación.
Principales métodos:
- Diseño del estudio basado en la población, transversal, de casos y controles.
- Se utilizaron datos de dos encuestas noruegas de salud pública (1984-1986, 1995-1997).
- Se analizaron 65.363 participantes, definiendo 3.113 casos con síntomas graves de reflujo y 39.872 controles.
Principales resultados:
- Existe una asociación dosis-respuesta significativa entre un mayor índice de masa corporal (IMC) y los síntomas de reflujo en ambos sexos.
- La asociación fue notablemente más fuerte en las mujeres (OR 6,3 para IMC >35) en comparación con los hombres (OR 3,3 para IMC >35).
- Las mujeres premenopáusicas mostraron un vínculo más fuerte entre el IMC y el reflujo que las mujeres posmenopáusicas; el uso de terapia hormonal amplificó esta asociación.
Conclusiones:
- Se confirma una sólida asociación entre la masa corporal y los síntomas de reflujo gastroesofágico.
- Este vínculo es significativamente más pronunciado en las mujeres, particularmente en las personas premenopáusicas.
- Los estrógenos, potencialmente a través de la terapia hormonal, pueden desempeñar un papel clave en el desarrollo de la enfermedad de reflujo.
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