title: Helicobacter pylori Serology Inversely Correlated With the Risk and Severity of Reflux Esophagitis in Helicobacter pylori Endemic Area: A Matched Case-Control Study of 5,616 Health Check-Up Koreans.
abstract: OBJECTIVE
  The role of Helicobacter pylori in gastroesophageal reflux disease remains still controversial and the effect of the organism on severity of reflux esophagitis have been rarely issued. The aim of this study was to investigate the relationship between H. pylori infection and reflux esophagitis, and especially the severity of reflux esophagitis.
  
  
  METHODS
  We performed a cross-sectional case-control study of 5,616 subjects undergoing both upper endoscopy and H. pylori serology during health Check-up (2,808 cases vs age- and sex-matched controls). Smoking, alcohol, body mass index and waist circum - ference were added to a multiple regression model.
  
  
  RESULTS
  Prevalence of H. pylori infection was lower in cases with reflux esophagitis than in controls (38.4% vs 58.2%, P < 0.001) and negative associations with H. pylori infection continued across the grade of esophagitis (46.7% in Los Angeles classification M [LA-M], 34.3% in LA-A or LA-B and 22.4% in LA-C or LA-D, P < 0.001). Positive serology for H. pylori independently reduced the risk of reflux esophagitis (adjusted OR, 0.44; 95% CI, 0.39-0.49). Notably, the negative associations continued across the grade of esophagitis with adjusted ORs of 0.63 in LA-M, 0.36 in LA-A or LA-B and 0.20 in LA-C or LA-D (P < 0.001).
  
  
  CONCLUSIONS
  In a age-sex matched Korean, H. pylori seropositivity was independently and inversely associated with the risk and severity of reflux esophagitis, suggesting the organism may have a protective role against gastroesophageal reflux disease.
authors.affiliation: Department of Internal Medicine, Healthcare Research Institute, Seoul National University Hospital Healthcare System Gangnam Center, Seoul, Korea.
authors.forename: Su Jin
authors.initials: SJ
authors.lastname: Chung
authors.forename: Seon Hee
authors.initials: SH
authors.lastname: Lim
authors.forename: Jeongmin
authors.initials: J
authors.lastname: Choi
authors.forename: Donghee
authors.initials: D
authors.lastname: Kim
authors.forename: Young Sun
authors.initials: YS
authors.lastname: Kim
authors.forename: Min Jeong
authors.initials: MJ
authors.lastname: Park
authors.forename: Jeong Yoon
authors.initials: JY
authors.lastname: Yim
authors.forename: Joo Sung
authors.initials: JS
authors.lastname: Kim
authors.forename: Sang-Heon
authors.initials: SH
authors.lastname: Cho
authors.forename: Hyun Chae
authors.initials: HC
authors.lastname: Jung
authors.forename: In Sung
authors.initials: IS
authors.lastname: Song