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肥胖和雌激素是胃食道逆流症状的危险因素
Magnus Nilsson1, Roar Johnsen, Weimin Ye
1Department of Surgery, Karolinska Institutet, Karolinska Hospital, Stockholm, Sweden. magnus.nilsson@ks.se
JAMA
|July 3, 2003
概括
肥胖症显著增加胃食道逆流风险,特别是在女性中. 这种联系在绝经前妇女中更强烈,受激素治疗的影响,表明雌激素在反流性疾病发展中的作用.
科学领域:
- 胃肠病学 胃肠病学
- 流行病学 流行病学
- 内分泌学 在内分泌学.
背景情况:
- 胃食道逆流和肥胖症正在引起越来越多的公共卫生问题.
- 现有证据将肥胖与反流症联系在一起是不一致的.
- 在这种关联中,已经提出了基于性别的差异.
研究的目的:
- 为了研究体质和胃食道逆流症状之间的关系.
- 确定女性性激素对这种关联的影响.
主要方法:
- 基于人群的,横截面的,病例控制研究设计.
- 利用了挪威两次公共卫生调查 (1984-1986,1995-1997) 的数据.
- 分析了65,363名参与者,确定了3,113名严重反流症状的病例和39,872名对照.
主要成果:
- 在男性和女性中,更高的体重指数 (BMI) 和反流症状之间存在显著的剂量反应关联.
- 与男性相比,女性的关联明显更强 (BMI>35的OR 6.3),而男性的关联 (BMI>35的OR 3.3).
- 绝经前妇女显示BMI和逆流之间的联系比绝经后妇女更强;使用激素治疗放大了这种联系.
结论:
- 证实了体质和胃食道逆流症状之间的强烈关联.
- 这种联系在女性,特别是绝经前的个体中明显明显.
- 雌激素,可能通过激素治疗,可能在逆流性疾病的发展中发挥关键作用.
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