Classification of adults suffering from typical gastroesophageal reflux disease symptoms: contribution of latent class analysis in a European observational study

BMC Gastroenterology

Research Article

Philippe Ducrotté¹  Angel Alvarez Sanchez²  Stanislas Bruley des Varannes³  Paul Bergmans⁴  Sofia Keim⁵  Silvia Marelli⁶  Esther Grahl⁷  Liudmila Usova⁸  Konstantinos Triantafyllou⁹  Renzo Cestari^1,10 

[1] CHU Rouen, Rouen, France;Hospital Clinico San Carlos, Madrid, Spain;Institut des Maladies de l’Appareil Digestif – CHU Hôtel Dieu, 44093, Nantes Cedex, France;Janssen-Cilag B.V, Tilburg, The Netherlands;Janssen-Cilag, Barcarena, Portugal;Janssen-Cilag, Milan, Italy;Janssen-Cilag, Neuss, Germany;Regional Clinic Hospital, Nizhny Novgorod, Russia;University General Hospital Attikon, Athens, Greece;Università degli Studi, Spedali Civili, Brescia, Italy;

关键词: GERD;    Acid related disease;    Adults;    Latent class analysis;    Symptoms;    Classification;   

DOI  :  10.1186/1471-230X-14-112

 received in 2014-02-25, accepted in 2014-05-22,  发布年份 2014

来源: Springer

【 摘 要 】

BackgroundAs illustrated by the Montreal classification, gastroesophageal reflux disease (GERD) is much more than heartburn and patients constitute a heterogeneous group. Understanding if links exist between patients’ characteristics and GERD symptoms, and classify subjects based on symptom-profile could help to better understand, diagnose, and treat GERD. The aim of this study was to identify distinct classes of GERD patients according to symptom profiles, using a specific statistical tool: Latent class analysis.MethodsAn observational single-visit study was conducted in 5 European countries in 7700 adults with typical symptoms. A latent class analysis was performed to identify “latent classes” and was applied to 12 indicator symptoms.ResultsOn 7434 subjects with non-missing indicators, latent class analysis yielded 5 latent classes. Class 1 grouped the highest severity of typical GERD symptoms during day and night, more digestive and non-digestive GERD symptoms, and bad sleep quality. Class 3 represented less frequent and less severe digestive and non-digestive GERD symptoms, and better sleep quality than in class 1. In class 2, only typical GERD symptoms at night occurred. Classes 4 and 5 represented daytime and nighttime regurgitation. In class 4, heartburn was also identified and more atypical digestive symptoms. Multinomial logistic regression showed that country, age, sex, smoking, alcohol use, low-fat diet, waist circumference, recent weight gain (>5 kg), elevated triglycerides, metabolic syndrome, and medical GERD treatment had a significant effect on latent classes.ConclusionLatent class analysis classified GERD patients based on symptom profiles which related to patients’ characteristics. Although further studies considering these proposed classes have to be conducted to determine the reproducibility of this classification, this new tool might contribute in better management and follow-up of patients with GERD.

【 授权许可】

CC BY   
© Bruley des Varannes et al.; licensee BioMed Central Ltd. 2014