Dataset Information

Prevalence and Predictors of Gastroesophageal Reflux Complications in Community Subjects.

ABSTRACT: Predictors of erosive esophagitis (EE) and Barrett's esophagus (BE) and the influence of number of risk factors in the community are not well defined.Rates of BE and EE among community residents identified in a randomized screening trial were defined. The risk of EE and BE associated with single and multiple risk factors (gender, age, GERD, Caucasian ethnicity, ever tobacco use, excess alcohol use, family history of BE or EAC, and central obesity) was analyzed.Sixty-eight (33 %) of 205 subjects had EE and/or BE. BE prevalence was 7.8 % with dysplasia present in 1.5 %. Rates were comparable between subjects with and without GERD. Male sex and central obesity were independent risk factors. The odds of EE or BE were 3.7 times higher in subjects with three or four risk factors and 5.7 times higher in subjects with five or more risk factors compared with those with two or less factors.EE and BE are prevalent in the community regardless of the presence of GERD. Risk appeared to be additive, increasing substantially with three or more risk factors.

SUBMITTER: Crews NR

PROVIDER: S-EPMC5069175 | biostudies-literature | 2016 Nov

REPOSITORIES: biostudies-literature

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Prevalence and Predictors of Gastroesophageal Reflux Complications in Community Subjects.

Crews Nicholas R NR Johnson Michele L ML Schleck Cathy D CD Enders Felicity T FT Wongkeesong Louis-Michel LM Wang Kenneth K KK Katzka David A DA Iyer Prasad G PG

Digestive diseases and sciences 20160810 11

<h4>Background</h4>Predictors of erosive esophagitis (EE) and Barrett's esophagus (BE) and the influence of number of risk factors in the community are not well defined.<h4>Methods</h4>Rates of BE and EE among community residents identified in a randomized screening trial were defined. The risk of EE and BE associated with single and multiple risk factors (gender, age, GERD, Caucasian ethnicity, ever tobacco use, excess alcohol use, family history of BE or EAC, and central obesity) was analyzed. ...[more]

PMID: 27510751

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Project description:The coexistence of gastroesophageal reflux disease (GERD) and COPD has been recognized, but there has been no comprehensive evaluation of the impact of GERD on COPD-related health status and patient-centered outcomes.Cross-sectional and longitudinal study of 4,483 participants in the COPDGene cohort who met GOLD criteria for COPD. Physician-diagnosed GERD was ascertained by questionnaire. Clinical features, spirometry and imaging were compared between COPD subjects without versus with GERD. We evaluated the relationship between GERD and symptoms, exacerbations and markers of microaspiration in univariate and multivariate models. Associations were additionally tested for the confounding effect of covariates associated with a diagnosis of GERD and the use of proton-pump inhibitor medications (PPIs). To determine whether GERD is simply a marker for the presence of other conditions independently associated with worse COPD outcomes, we also tested models incorporating a GERD propensity score.GERD was reported by 29% of subjects with female predominance. Subjects with GERD were more likely to have chronic bronchitis symptoms, higher prevalence of prior cardiovascular events (combined myocardial infarction, coronary artery disease and stroke 21.3% vs. 13.4.0%, p?<?0.0001). Subjects with GERD also had more severe dyspnea (MMRC score 2.2 vs. 1.8, p?<?0.0001), and poorer quality of life (QOL) scores (St. George's Respiratory Questionnaire (SGRQ) total score 41.8 vs. 34.9, p?<?0.0001; SF36 Physical Component Score 38.2 vs. 41.4, p?<?0.0001). In multivariate models, a significant relationship was detected between GERD and SGRQ (3.4 points difference, p?<?0.001) and frequent exacerbations at baseline (?2 exacerbation per annum at inclusion OR 1.40, p?=?0.006). During a mean follow-up time of two years, GERD was also associated with frequent (?2/year exacerbations OR 1.40, p?=?0.006), even in models in which PPIs, GERD-PPI interactions and a GERD propensity score were included. PPI use was associated with frequent exacerbator phenotype, but did not meaningfully influence the GERD-exacerbation association.In COPD the presence of physician-diagnosed GERD is associated with increased symptoms, poorer QOL and increased frequency of exacerbations at baseline and during follow-up. These associations are maintained after controlling for PPI use. The PPI-exacerbations association could result from confounding-by-indication.

Dataset Information

Prevalence and Predictors of Gastroesophageal Reflux Complications in Community Subjects.

Publications

Prevalence and Predictors of Gastroesophageal Reflux Complications in Community Subjects.

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