Association of body mass index with heartburn, regurgitation and esophagitis: results of the Progression of Gastroesophageal Reflux Disease study.
BACKGROUND
Overweight and obesity are believed to be risk factors for gastroesophageal reflux disease (GERD). The aim of the present study was to analyze the impact of body mass index (BMI) on the severity and frequency of reflux symptoms and esophagitis in a large cohort of reflux patients.


METHODS
As part of the Progression of Gastroesophageal Reflux Disease (ProGERD) study, 6215 patients with clinically assessed GERD were included in the present investigation (53% male, 52 +/- 14 years; 47% female, 56 +/- 14 years). Heartburn and regurgitation symptoms were assessed using the validated Reflux Disease Questionnaire. Endoscopies were performed and patients were subsequently classified as having non-erosive or erosive disease. To examine the association between BMI, GERD symptoms, and esophagitis, odds ratios (OR) and 95% confidence intervals (95%CI) were calculated using logistic regression models.


RESULTS
In patients with GERD, higher BMI was associated with more frequent and more severe heartburn and regurgitation, as well as with esophagitis. The effects were more pronounced for regurgitation than for heartburn. The strongest association was between obesity and severity of regurgitation symptoms (women: OR 2.11, 95%CI 1.60-2.77; men: OR 2.15, 95%CI 1.59-2.90). Obese women, but not men, had an increased risk of severe esophagitis compared to women with normal weight (OR 2.51, 95%CI 1.53-4.12).


CONCLUSIONS
In patients with GERD, higher BMI was associated with more severe and more frequent reflux symptoms and esophagitis.
Nocon
Marc
M
Institute for Social Medicine, Epidemiology, and Health Economics, Charité University Medical Center, Berlin, Germany. marc.nocon@charite.de
Labenz
Joachim
J
Jaspersen
Daniel
D
Meyer-Sabellek
Wolfgang
W
Stolte
Manfred
M
Lind
Tore
T
Malfertheiner
Peter
P
Willich
Stefan N
SN
D000328:Adult; D000368:Aged; D015992:Body Mass Index; D018450:Disease Progression; D004941:Esophagitis / Q000209:etiology* / Q000473:pathology / Q000503:physiopathology; D004945:Esophagoscopy; D005260:Female; D005764:Gastroesophageal Reflux / Q000209:etiology* / Q000473:pathology / Q000503:physiopathology; D006356:Heartburn / Q000209:etiology* / Q000473:pathology / Q000503:physiopathology; D006801:Humans; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications* / Q000473:pathology / Q000503:physiopathology; D016017:Odds Ratio; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D012737:Sex Factors; D011795:Surveys and Questionnaires