title: Risk factors for erosive and non-erosive gastroesophageal reflux disease and Barrett's esophagus in Nothern Sardinia.
abstract: OBJECTIVE
  Gastroesophageal reflux disease (GERD) and esophageal adenocarcinoma have been increasing. We studied the relationship of conventional risk factors and Helicobacter pylori infection in patients with erosive and non-erosive GERD and Barrett's esophagus.
  
  
  METHODS
  This was a retrospective study of dyspeptic patients undergoing upper endoscopy between 2002 and 2013. Following endoscopy, those with previously undiagnosed GERD were sub-grouped into non-erosive GERD (NERD), erosive GERD (eGERD), or Barrett's esophagus. H. pylori status was confirmed by 2 positive tests.
  
  
  RESULTS
  About 5156 patients were included, GERD was present in 65.6% including 1992 with NERD and 1392 with eGERD. About 1772 dyspeptic patients without symptoms of reflux and/or esophagitis served as controls. A hiatal hernia increased the risk of both eGERD and NERD. eGERD was more prevalent among the obese (OR =1.72, p < 0.001), men (OR =1.38, p < 0.001) and current smokers. Helicobacter pylori infection was significantly more common among those with NERD (OR =1.17 versus 1.01, p = 0.046). Logistic regression analysis for eGERD and NERD using age, gender, body mass index, H. pylori infection, hiatal hernia, and smoking showed that overweight and hiatal hernia were significant risk factors for eGERD, and female gender for NERD. Male gender, eGERD and age >50 years were the major risk factors for Barrett's esophagus.
  
  
  CONCLUSIONS
  The epidemiology of eGERD and NERD suggests differences in pathogenesis, and prevention and treatment strategies should be separately examined in men and women.
authors.affiliation: a Dipartimento Di Medicina Clinica E Sperimentale , University of Sassari , Sassari , Italy ;|b Baylor College of Medicine , Houston , TX , USA ;
authors.forename: Maria Pina
authors.initials: MP
authors.lastname: Dore
authors.affiliation: a Dipartimento Di Medicina Clinica E Sperimentale , University of Sassari , Sassari , Italy ;
authors.forename: Giovanni Mario
authors.initials: GM
authors.lastname: Pes
authors.affiliation: c Dipartimento Di Medicina , University of Perugia Medical School , Perugia , Italy.
authors.forename: Gabrio
authors.initials: G
authors.lastname: Bassotti
authors.affiliation: a Dipartimento Di Medicina Clinica E Sperimentale , University of Sassari , Sassari , Italy ;
authors.forename: Maria Antonietta
authors.initials: MA
authors.lastname: Farina
authors.affiliation: a Dipartimento Di Medicina Clinica E Sperimentale , University of Sassari , Sassari , Italy ;
authors.forename: Giuseppina
authors.initials: G
authors.lastname: Marras
authors.affiliation: b Baylor College of Medicine , Houston , TX , USA ;
authors.forename: David Yates
authors.initials: DY
authors.lastname: Graham
mesh_terms: D000328:Adult; D001471:Barrett Esophagus / Q000150:complications* / Q000175:diagnosis; D005260:Female; D005764:Gastroesophageal Reflux / Q000150:complications* / Q000175:diagnosis; D005773:Gastroscopy; D016481:Helicobacter Infections / Q000453:epidemiology*; D016480:Helicobacter pylori / Q000302:isolation & purification; D006551:Hernia, Hiatal / Q000453:epidemiology; D006801:Humans; D007558:Italy; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology
keywords: Age; H. pylori infection; esophageal cancer; gender; obesity; risk factors