The impact of body mass index and Helicobacter pylori infection on gastro-oesophageal reflux symptoms: a population-based study in Northern Norway.
OBJECTIVE
Increased body mass index (BMI) has been proposed as a risk factor for gastro-oesophageal reflux symptoms. The aim of this study was to evaluate the effect of BMI and Helicobacter pylori on reflux symptoms in an adult population.


METHODS
For this cross-sectional, population-based study from Bodø and Sørreisa communities in Northern Norway, a total of 3927 adults were invited to complete a questionnaire on gastrointestinal symptoms and to provide stool samples for the assessment of H. pylori. Reflux symptoms were considered present when a reflux syndrome score was > or =2 according to the Gastrointestinal Symptom Rating Scale (GSRS).


RESULTS
The response rate was 44.2%, and 44.7% of the respondents were male. Age-adjusted prevalences were: for overweight, 35.6% (95% CI (32.4%; 38.8%)); for obesity, 10.0% (8.4%; 11.6%); for H. pylori: 21.2% (19.1%; 23.9%) and for reflux symptoms: 21.7% (19.5%; 23.9%). In the logistic regression analyses, H. pylori and smoking were not risk factors for reflux symptoms, whereas male gender (OR 4.78 (95%CI (1.88; 12.1)), age (1.01 (1.00; 1.03)) and overweight (1.51 (1.14; 2.00)) were. When stratified by gender, overweight and age were independent risk factors for reflux symptoms in females only, whereas H. pylori infection was protective against such symptoms in men. Models including these parameters could only explain 3% of the variations in reflux symptoms.


CONCLUSIONS
BMI is an independent risk factor for gastro-oesophageal reflux symptoms among healthy female adults, but contributes only to a minor part of the variation in these symptoms. H. pylori is protective against reflux symptoms in men.
Breckan
Ragnar K
RK
Department of Internal Medicine, Nordland Hospital, Bodø, Norway. rbreckan@online.no
Paulssen
Eyvind J
EJ
Asfeldt
Anne Mette
AM
Mortensen
Liisa
L
Straume
Bjørn
B
Florholmen
Jon
J
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D016009:Chi-Square Distribution; D003430:Cross-Sectional Studies; D005260:Female; D005764:Gastroesophageal Reflux / Q000453:epidemiology / Q000209:etiology*; D016481:Helicobacter Infections / Q000150:complications*; D016480:Helicobacter pylori; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009664:Norway / Q000453:epidemiology; D009765:Obesity / Q000150:complications* / Q000453:epidemiology; D015995:Prevalence; D012307:Risk Factors; D012737:Sex Factors; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires