The association between objective tongue color and endoscopic findings: results from the Kyushu and Okinawa population study (KOPS)

BMC Complementary and Alternative Medicine

Jun Hayashi⁴  Takao Namiki⁶  Toshiya Nakaguchi⁵  Takeshi Oji⁶  Takeshi Ihara¹  Masaharu Nagata²  Yoshihisa Urita³  Norihiro Furusyo¹  Mosaburo Kainuma¹ 

[1] Department of General Internal Medicine, Kyushu University Hospital, 3-1-1Maidashi, Higashi-ku 812-8582, Fukuoka, Japan;Community Medicine Education Unit, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku 812-8582, Fukuoka, Japan;Department of General Medicine and Emergency Care, Toho University School of Medicine, Omori Hospital, 6-11-1Omori-nishi, Ota-ku 143-8541, Tokyo, Japan;Kyushu General Medicine Center, Haradoi Hospital, 6-40-8Aoba, Higashi-ku 813-8588, Fukuoka, Japan;Center for Frontier Medical Engineering, Chiba University, 1-33Yayoicho, Inage-ku 263-8522, Chiba, Japan;Department of Japanese Oriental (Kampo) Medicine, Graduate School of Medicine, Chiba University, 1-8-1Inohana, Chuo-ku 260-8670, Chiba, Japan

关键词: Evidenced Based Medicine;    Helicobacter pylori;    Endoscopic finding;    Tongue color;   

Others  :  1233227
DOI  :  10.1186/s12906-015-0904-0

 received in 2015-03-29, accepted in 2015-10-07,  发布年份 2015

【 摘 要 】

Background

The relation between tongue color and gastroesophageal disease is unclear. This study was done to investigate the associations between tongue color (TC), endoscopic findings, Helicobacter.pylori infection status, and serological atrophic gastritis (SAG).

Methods

The participants were 896 residents of Ishigaki Island, Okinawa, aged 28–86 years. The tongue was photographed, esophagogastroduodenoscopy was done, and serum antibody to H.pylori was measured. SAG was defined as a serum Pepsinogen (PG)Ilevel ≤70 ng/ml and a PGI/IIratio ≤3.0. TC was measured by the device-independent international commission on Illumination 1976 L*a*b* color space standards at four points: (1) edge, (2) posterior, (3) middle, and (4) apex. We also calculated the ratio of the tongue edge to the three other measured points to examine the association between the coating of the tongue and the endoscopic and laboratory findings.

Results

Participants were excluded who had two or more endoscopic findings (n = 315) or who had SAG without seropositivity to H.pylori (n = 33). The remaining 548 participants were divided into three groups: SAG and seropositive to H.pylori (n = 67), seropositive to H.pylori alone (n = 56), and without SAG and seronegative for H.pylori (n = 425). We divided 425 residents into a single endoscopic finding positive group (n = 207) and a negative group, which served as a control (n = 218). The most frequent single endoscopic finding was esophageal hernia (n = 110), followed by erosive esophagitis (n = 35) and erosive gastritis (EG) (n = 45). EH was significantly associated with TC (2b*/1b*) (P < 0.05). EG was significantly associated with TC (3a*, 3b*) (P < 0.05). Seropositivity to H.pylori was significantly associated with TC (3 L*, 3 L*/1 L*) (P < 0.05, <0.01), and seropositivity to both H.pylori and SAG was significantly associated with TC (3 L*/1 L*) (P < 0.05). Multivariate analysis extracted TC (3a*, 3b*) as an independent factor associated with a differential diagnosis of EG (Odds ratio (OR) 2.66 P = 0.008, OR 2.17 P = 0.045).

Conclusions

The tongue body color of the middle area reflects acute change of gastric mucosa, such as erosive gastritis. Tongue diagnosis would be a useful, non-invasive screening tool for EG.

【 授权许可】

   
2015 Kainuma et al.

【 图 表 】

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