title: Increased risk of concurrent gastroesophageal reflux disease among patients with Sjögren's syndrome: A nationwide population-based study.
abstract: BACKGROUND
  Little data is available on the risk of gastroesophageal reflux disease in patients diagnosed with Sjögren's syndrome.
  
  
  METHODS
  We identified 4650 Sjögren's syndrome patients between 2000 and 2011 from the National Health Insurance Research Database. Each Sjögren's syndrome patient was matched to 4 controls based on age, sex, and index year, and all subjects were followed up from the index date to December 31, 2011. Cox proportional hazards regression model was used to estimate the risk of gastroesophageal reflux disease.
  
  
  RESULTS
  The risk of gastroesophageal reflux disease for Sjögren's syndrome patients was 2.41-fold greater than that for the comparison cohort after adjusting for age, sex, and comorbidities. In age stratified analyses, the youngest Sjögren's syndrome cohort (age: 20-44years old) had the highest risk (HR=3.02; 95% CI=2.48-3.69) and the lowest risk at age ≥65years (HR=1.95; 95% CI=1.61-2.36). Regardless of in subjects with and without comorbidity, Sjögren's syndrome patients had a higher risk than the controls. Sjögren's syndrome subjects with ischemic heart disease, hyperlipidemia and renal disease had the highest risk for gastroesophageal reflux disease compared with the comparison cohort without those diseases (HR=7.67; 95% CI=5.32-11.1).
  
  
  CONCLUSIONS
  Patients with Sjögren's syndrome have a significantly greater risk of developing subsequent gastroesophageal reflux disease than the general population.
authors: Department of Neurology, Changhua Christian Hospital, Changhua, Taiwan; Department of Medical Laboratory Science and Biotechnology, and Medical Imaging and Radiological Sciences, Central Taiwan University of Science and Technology, Taichung, Taiwan.
authors: Chen-Shu
authors: CS
authors: Chang
authors: Department of Psychiatry, China Medical University Hospital, Taichung, Taiwan; Graduate Institute of Clinical Medicine Science and School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan.
authors: Chun-Hui
authors: CH
authors: Liao
authors: Management Office for Health Data, China Medical University, Taichung, Taiwan; School of Medicine, China Medical University, Taichung, Taiwan.
authors: Chih-Hsin
authors: CH
authors: Muo
authors: Graduate Institute of Clinical Medicine Science and School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan; Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung, Taiwan. Electronic address: d10040@mail.cmuh.org.tw.
authors: Chia-Huang
authors: CH
authors: Kao
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D015897:Comorbidity; D016208:Databases, Factual; D005260:Female; D005764:Gastroesophageal Reflux / Q000453:epidemiology*; D006801:Humans; D006949:Hyperlipidemias / Q000453:epidemiology; D015994:Incidence; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D017678:Sex Distribution; D012859:Sjogren's Syndrome / Q000150:complications*; D013624:Taiwan / Q000453:epidemiology; D055815:Young Adult
keywords: Autoimmune; Gastroesophageal reflux disease; Sjögren's syndrome