title: Classification of adults suffering from typical gastroesophageal reflux disease symptoms: contribution of latent class analysis in a European observational study.
abstract: BACKGROUND
  As 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.
  
  
  METHODS
  An 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.
  
  
  RESULTS
  On 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.
  
  
  CONCLUSIONS
  Latent 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.
authors: Institut des Maladies de l'Appareil Digestif - CHU Hôtel Dieu, 44093 Nantes Cedex, France. stanislas.bruleydesvarannes@chu-nantes.fr.
authors: Stanislas
authors: S
authors: Bruley des Varannes
authors: Renzo
authors: R
authors: Cestari
authors: Liudmila
authors: L
authors: Usova
authors: Konstantinos
authors: K
authors: Triantafyllou
authors: Angel
authors: A
authors: Alvarez Sanchez
authors: Sofia
authors: S
authors: Keim
authors: Paul
authors: P
authors: Bergmans
authors: Silvia
authors: S
authors: Marelli
authors: Esther
authors: E
authors: Grahl
authors: Philippe
authors: P
authors: Ducrotté
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000428:Alcohol Drinking / Q000453:epidemiology; D018752:Diet, Fat-Restricted / Q000706:statistics & numerical data; D005260:Female; D005602:France / Q000453:epidemiology; D005764:Gastroesophageal Reflux / Q000145:classification* / Q000453:epidemiology / Q000503:physiopathology; D006115:Greece / Q000453:epidemiology; D006801:Humans; D015228:Hypertriglyceridemia / Q000453:epidemiology; D007558:Italy / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D024821:Metabolic Syndrome / Q000453:epidemiology; D008875:Middle Aged; D012426:Russia / Q000453:epidemiology; D012720:Severity of Illness Index; D012737:Sex Factors; D012907:Smoking / Q000453:epidemiology; D013030:Spain / Q000453:epidemiology; D055105:Waist Circumference