title: Association of body mass index with heartburn, regurgitation and esophagitis: results of the Progression of Gastroesophageal Reflux Disease study.
abstract: 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.
authors.affiliation: Institute for Social Medicine, Epidemiology, and Health Economics, Charité University Medical Center, Berlin, Germany. marc.nocon@charite.de
authors.forename: Marc
authors.initials: M
authors.lastname: Nocon
authors.forename: Joachim
authors.initials: J
authors.lastname: Labenz
authors.forename: Daniel
authors.initials: D
authors.lastname: Jaspersen
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Meyer-Sabellek
authors.forename: Manfred
authors.initials: M
authors.lastname: Stolte
authors.forename: Tore
authors.initials: T
authors.lastname: Lind
authors.forename: Peter
authors.initials: P
authors.lastname: Malfertheiner
authors.forename: Stefan N
authors.initials: SN
authors.lastname: Willich
mesh_terms: 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