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肥満とエストロゲンは,胃食道逆流症の症状の危険因子である
Magnus Nilsson1, Roar Johnsen, Weimin Ye
1Department of Surgery, Karolinska Institutet, Karolinska Hospital, Stockholm, Sweden. magnus.nilsson@ks.se
JAMA
|July 3, 2003
まとめ
肥満は,特に女性では,胃食道逆流症のリスクを大幅に増加させます. この関連性は,更年期前の女性ではより強く,ホルモン療法の影響を受け,反流性疾患の発症におけるエストロゲンの役割を示唆しています.
科学分野:
- 胃腸内科 胃腸内科
- エピデミオロジー エピデミオロジー
- エンドクリノロジー エンドクリノロジー
背景:
- 胃食道逆流と肥満は,公衆衛生上の懸念が高まっています.
- 肥満と逆流を結びつける既存の証拠は矛盾しています.
- この関連性における性別による差異が示唆されている.
研究 の 目的:
- 体重と胃食道逆流症の症状の関係を調べるために.
- この関連性に対する女性性ホルモンの影響を判断する.
主な方法:
- 人口ベースの,横断的,症例対照研究デザイン.
- ノルウェーの2つの公衆衛生調査 (1984年 - 1986年,1995年 - 1997年) のデータを活用した.
- 65,363人の参加者を分析し,重度の反流症状のある3,113人の症例と39,872人の対照群を定義しました.
主要な成果:
- 高いボディマス指数 (BMI) と両性における逆流症状の間には,有意な用量反応関連が存在します.
- この関連性は,男性と比較して女性 (OR 6.3 BMI >35の場合) と男性 (OR 3.3 BMI >35の場合) で著しく強かった.
- 閉経前の女性は閉経後の女性よりもBMIと逆流の間の強い関連性を示した;ホルモン療法の使用は,この関連性を増幅した.
結論:
- 体重と胃食道逆流症の症状との強い関連が確認されています.
- この関連性は,女性,特に閉経前の個人に著しく顕著です.
- エストロゲンは,潜在的にホルモン療法を通じて,逆流症の発達に重要な役割を果たす可能性があります.
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