Lifestyle factors affecting gastroesophageal reflux disease symptoms: a cross-sectional study of healthy 19864 adults using FSSG scores

BMC Medicine

Kazuhiko Koike¹  Toru Mitsushima²  Mitsuhiro Fujishiro¹  Chihiro Minatsuki¹  Shinya Kodashima¹  Satoshi Ono¹  Keiko Niimi¹  Chihiro Takeuchi¹  Yu Takahashi¹  Maki Konno-Shimizu¹  Takeshi Shimamoto²  Rie Mikami-Matsuda¹  Itsuko Asada-Hirayama¹  Satoshi Mochizuki¹  Nobutake Yamamichi¹ 

[1] Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, Japan;Kameda Medical Center Makuhari, CD-2, 1-3, Nakase, Mihama-ku, Chiba-city, Japan

关键词: histamine H₂-receptor antagonist (H₂RA);    proton pump inhibitor (PPI);    dietary habits;    quality of sleep;    FSSG (Frequency Scale for the Symptoms of GERD);    gastroesophageal reflux disease (GERD);   

Others  :  1126208
DOI  :  10.1186/1741-7015-10-45

 received in 2011-12-22, accepted in 2012-05-03,  发布年份 2012

【 摘 要 】

Background

Gastroesophageal reflux disease (GERD) is a very common disorder worldwide, comprised of reflux esophagitis (RE) and non-erosive reflux disease (NERD). As more than half of GERD patients are classified into the NERD group, precise evaluation of bothersome epigastric symptoms is essential. Nevertheless, compared with many reports targeting endoscopic reflux esophagitis, large-scale studies focusing on GERD symptoms have been very scarce.

Methods

To elucidate lifestyle factors affecting GERD symptoms, 19,864 healthy adults in Japan were analyzed. Sub-analyses of 371 proton pump inhibitor (PPI) users and 539 histamine H₂-receptor antagonist (H₂RA) users were also performed. Using the FSSG (Frequency Scale for the Symptoms of GERD) score as a response variable, 25 lifestyle-related factors were univariately evaluated by Student's t-test or Pearson's correlation coefficient, and were further analyzed with multiple linear regression modelling.

Results

Average FSSG scores were 4.8 ± 5.2 for total subjects, 9.0 ± 7.3 for PPI users, and 8.2 ± 6.6 for H₂RA users. Among the total population, positively correlated factors and standardized coefficients (β) for FSSG scores are inadequate sleep (β = 0.158), digestive drug users (β = 0.0972 for PPI, β = 0.0903 for H₂RA, and β = 0.104 for others), increased body weight in adulthood (β = 0.081), dinner just before bedtime (β = 0.061), the habit of midnight snack (β = 0.055), lower body mass index (β = 0.054), NSAID users (β = 0.051), female gender (β = 0.048), lack of breakfast (β = 0.045), lack of physical exercise (β = 0.035), younger age (β = 0.033), antihyperglycemic agents non-users (β = 0.026), the habit of quick eating (β = 0.025), alcohol drinking (β = 0.025), history of gastrectomy (β = 0.024), history of cardiovascular disease (β = 0.020), and smoking (β = 0.018). Positively correlated factors for PPI users are female gender (β = 0.198), inadequate sleep (β = 0.150), lack of breakfast (β = 0.146), antihypertensive agent non-users (β = 0.134), and dinner just before bedtime (β = 0.129), whereas those for H₂RA users are inadequate sleep (β = 0.248), habit of midnight snack (β = 0.160), anticoagulants non-users (β = 0.106), and antihypertensive agents non-users (β = 0.095).

Conclusions

Among many lifestyle-related factors correlated with GERD symptoms, poor quality of sleep and irregular dietary habits are strong risk factors for high FSSG scores. At present, usual dose of PPI or H₂RA in Japan cannot fully relieve GERD symptoms.

【 授权许可】

   
2012 Yamamichi et al; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

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