Background Factors of Reflux Esophagitis and Non-Erosive Reflux Disease A Cross-Sectional Study of 10,837 Subjects in Japan.docVIP

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Background Factors of Reflux Esophagitis and Non-Erosive Reflux Disease A Cross-Sectional Study of 10,837 Subjects in Japan.doc

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Background Factors of Reflux Esophagitis and Non-Erosive Reflux Disease A Cross-Sectional Study of 10,837 Subjects in Japan

BackgroundFactorsofRefluxEsophagitisandNon- ErosiveRefluxDisease:ACross-SectionalStudyof10,837 SubjectsinJapan ChihiroMinatsuki1,NobutakeYamamichi1*,TakeshiShimamoto2,HikaruKakimoto1,YuTakahashi1, MitsuhiroFujishiro1,YoshikiSakaguchi1,ChiemiNakayama1,MakiKonno-Shimizu1,RieMatsuda1, SatoshiMochizuki1,ItsukoAsada-Hirayama1,YosukeTsuji1,ShinyaKodashima1,SatoshiOno1, KeikoNiimi1,ToruMitsushima2,KazuhikoKoike1 1DepartmentofGastroenterology,GraduateSchoolofMedicine,TheUniversityofTokyo,Tokyo,Japan,2KamedaMedicalCenterMakuhari,Chiba-shi,Japan Abstract Background: Despite thehigh prevalence ofgastroesophageal reflux disease(GERD), its risk factorsarestill asubject of controversy.Thisisprobablyduetoinadequatedistinctionbetweenrefluxesophagitis(RE)andnon-erosiverefluxdisease (NERD),andisalsoduetoinadequateevaluationofadjacentstomach.Ouraimisthereforetodefinebackgroundfactorsof REandNERDindependently,basedontheevaluationofHelicobacterpyloriinfectionandgastricatrophy. Methods:Weanalyzed10,837healthyJapanesesubjects(6,332menand4,505women,aged20–87years)whounderwent uppergastrointestinalendoscopy.REwasdiagnosedasthepresenceofmucosalbreak,andNERDwasdiagnosedasthe presenceofheartburnand/oracidregurgitationinRE-freesubjects.UsingGERD-freesubjectsascontrol,backgroundfactors forREandNERDwereseparatelyanalyzedusinglogisticregressiontoevaluatestandardizedcoefficients(SC),oddsratio (OR),andp-value. Results: Of the 10,837 study subjects, we diagnosed 733 (6.8%) as RE and 1,722 (15.9%) as NERD. For RE, male gender (SC=0.557,OR=1.75),HPnon-infection(SC=0.552,OR=1.74),higherpepsinogenI/IIratio(SC=0.496,OR=1.64),higher BMI (SC=0.464, OR=1.60), alcohol drinking (SC=0.161, OR=1.17), older age (SC=0.148, OR=1.16), and smoking (SC=0.129, OR=1.14) are positively correlated factors. For NERD, HP infection (SC=0.106, OR=1.11), female gender (SC=0.099, OR=1.10), younger age (SC=0.099, OR=1.10), higher pepsinogen I/II ratio (SC=0.099, OR=1.10), smoking (SC=0.080, OR=1.08), higher BMI (SC=0.078