Dataset Information

Gender-specific Effect of Micronutrient on Non-erosive Reflux Disease and Erosive Esophagitis.

ABSTRACT:

Background/aims

The effect of dietary micronutrients on non-erosive reflux disease (NERD) and reflux esophagitis is unclear. We aim to evaluate the gender-specific effect of micronutrient on erosive esophagitis and NERD.

Methods

A total of 11 690 participants underwent endoscopy and completed 3-day recordings for dietary intake and questionnaires for reflux symptoms from 2004 to 2008. To evaluate the effect of dietary micronutrients on NERD or erosive esophagitis, adjusted regression analysis with odds ratio (OR) and 95% confidence interval (CI) was used. In addition, we performed gender-specific analysis.

Results

Prevalence of NERD and erosive esophagitis was 6.8% and 11.2% in men and 9.1% and 2.4% in women. In adjusted analysis, high intake of vitamin A (OR, 0.78; 95% CI, 0.64-0.96), retinol (OR, 0.73; 95% CI, 0.59-0.90), vitamin B2 (OR, 0.68; 95% CI, 0.54-0.87), vitamin B6 (OR, 0.75; 95% CI, 0.58-0.96), folic acid (OR, 0.77; 95% CI, 0.62-0.96), calcium (OR, 0.66; 95% CI, 0.53-0.82), and iron (OR, 0.68; 95% CI, 0.53-0.87) had an inverse association with NERD. However, erosive esophagitis has no relationship with micronutrients except vitamin C (OR, 0.78; 95% CI, 0.62-0.98). High dietary intake of calcium reduced the risk of NERD in men and high dietary intake of many micronutrients reduced NERD in women.

Conclusions

While many dietary micronutrients reduced NERD, they had no effect on erosive esophagitis. The effect of micronutrient on NERD was more prominent in women than men.

SUBMITTER: Nam SY

PROVIDER: S-EPMC6326192 | biostudies-literature | 2019 Jan

REPOSITORIES: biostudies-literature

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Publications

Gender-specific Effect of Micronutrient on Non-erosive Reflux Disease and Erosive Esophagitis.

Nam Su Youn SY Park Bum Joon BJ Cho Yeong-Ah YA Ryu Kum Hei KH

Journal of neurogastroenterology and motility 20190101 1

<h4>Background/aims</h4>The effect of dietary micronutrients on non-erosive reflux disease (NERD) and reflux esophagitis is unclear. We aim to evaluate the gender-specific effect of micronutrient on erosive esophagitis and NERD.<h4>Methods</h4>A total of 11 690 participants underwent endoscopy and completed 3-day recordings for dietary intake and questionnaires for reflux symptoms from 2004 to 2008. To evaluate the effect of dietary micronutrients on NERD or erosive esophagitis, adjusted regress ...[more]

PMID: 30646479

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Project description:Background and study aims ?Non-erosive reflux disease (NERD) includes minimal change esophagitis (MCE) and no endoscopic abnormalities. However, for most endoscopists, it is difficult to detect MCE with conventional white-light endoscopy (WLE). Linked color imaging (LCI) technology is the most recently developed image-enhancing technology and improves detection and differentiation of subtle mucosal changes using a color contrast method. This study assessed the efficacy of WLE combined with LCI for diagnosing MCE compared with WLE. Patients and methods ?Between February and May 2017, 44 NERD patients and 40 healthy subjects were enrolled in our study. First, the distal esophagus was examined using WLE followed by LCI. Second, three experienced endoscopists observed all the patients' white-light (WL) images and corresponding images of WL and LCI and then recorded presence or absence of minimal change esophagitis (MCE?+/-). The proportion of minimal change between the two groups was then compared. Third, five blinded endoscopists with different levels of endoscopic experience assessed whether MCE was present. Intraobserver reproducibility and interobserver agreement were described using the kappa value. Results ?The proportion of MCE in the NERD group (70.8?%, 35/48) was higher than that in the control group (22.5?%, 9/40, P ?<?0.001) when diagnosed by the three experienced endoscopists. Detection rates for MCE using WLE combined with LCI were higher than those using WLE (43/88, 48.9?% vs. 29/88, 33.0?%, P ?<?0.001). With WLE combined with LCI, intraobserver reproducibility signi?cantly improved, indicating that the combined approach can improve interobserver agreement compared with using WLE alone. Conclusions ?Endoscopic diagnosis of MCE using WLE combined with LCI images is effective. Intraobserver reproducibility and interobserver agreement in MCE can be improved when LCI is applied with conventional imaging (Clinical trial registration number: NCT03068572).

Project description:BackgroundDespite the high prevalence of gastroesophageal reflux disease (GERD), its risk factors are still a subject of controversy. This is probably due to inadequate distinction between reflux esophagitis (RE) and non-erosive reflux disease (NERD), and is also due to inadequate evaluation of adjacent stomach. Our aim is therefore to define background factors of RE and NERD independently, based on the evaluation of Helicobacter pylori infection and gastric atrophy.MethodsWe analyzed 10,837 healthy Japanese subjects (6,332 men and 4,505 women, aged 20-87 years) who underwent upper gastrointestinal endoscopy. RE was diagnosed as the presence of mucosal break, and NERD was diagnosed as the presence of heartburn and/or acid regurgitation in RE-free subjects. Using GERD-free subjects as control, background factors for RE and NERD were separately analyzed using logistic regression to evaluate standardized coefficients (SC), odds ratio (OR), and p-value.ResultsOf 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), HP non-infection (SC = 0.552, OR = 1.74), higher pepsinogen I/II ratio (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, OR = 1.08), and alcohol drinking (SC = 0.076, OR = 1.08) are positively correlated factors. Prevalence of RE in subjects with chronic HP infection and successful HP eradication denotes significant difference (2.3% and 8.8%; p<0.0001), whereas that of NERD shows no difference (18.2% and 20.8%; p = 0.064).ConclusionsSignificantly associated factors of NERD are considerably different from those of RE, indicating that these two disorders are pathophysiologically distinct. Eradication of Helicobacter pylori may have disadvantageous effects on RE but not on NERD.

Dataset Information

Gender-specific Effect of Micronutrient on Non-erosive Reflux Disease and Erosive Esophagitis.

Background/aims

Methods

Results

Conclusions

Publications

Gender-specific Effect of Micronutrient on Non-erosive Reflux Disease and Erosive Esophagitis.

Similar Datasets

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