위식도역류질환의 내시경 중증도와 비만관련 지표들과의 연관성
Correlation between Endoscopic Severity of Gastroesophageal Reflux Disease (GERD) and Indexes of Obesity
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연구배경: 비만 관련 지표인 체질량지수, 허리둘레, 체지방률 과 복부지방률에 따른 위식도 역류질환(gastroesophageal refl ux disease, GERD)의 상부 위장관 내시경적 중증도와의 연관성을 알기 위해 본 연구를 시행하였다. 방법: 2007년 1월부터 2008넌 3월까지 일개 종합병원 건강 검진센터를 내원하여 상부 위장관 내시경을 실시한 사람들 8,325명 중, 설문지를 통해 흉부 작열감과 위산 역류증상을 호 소하는 678명 중에서 약제를 복용중이거나 과거 상부 위장관 의 수술병력 등이 있는 사람들을 제외한 527명을 연구 대상으 로 하였다. GERD의 그룹은 LA grade classifi cation system에 따라 분류하였다. 결과: 비미란성 역류질환(non-erosive refl ux disease, NERD)은 125명, LA A 254명, LA B 105명, LA C 43명이었다. LA A, LA B, LA C 그룹으로 갈수록 남자, 흡연자, 하루 3잔 이상의 음주자 가 유의하게 많았다(P<0.001). 성별, 흡연, 음주를 포함시켜 각 비만관련지표마다 순서로지스틱 분석을 실시한 결과, 남자 일 경우와 음주를 주 5회 이상 할 경우에 위식도역류질환의 내 시경적 중증도가 높은 그룹에 속할 확률이 높았다. 체질량지 수와 허리둘레가 비만인 경우 위식도역류질환의 내시경적 중증도가 높은 그룹에 속할 확률이 높았으며(각각 OR, 2.065, 2.394; P<0.05), 체지방률의 경우는 남자에서만, 비만한 경우 위식도역류질환의 내시경적 중증도가 높은 그룹에 속할 확률 이 높았다(OR ,1.906; P<0.001). 결론: 비만 관련지표들 중 체질량지수, 체지방률(남자에서 만), 허리둘레가 비만인 경우 위식도역류질환의 내시경적 중 증도가 높은 그룹에 속할 확률이 높다. 특히 남자일 경우와 음 주를 주 5회 이상 할 경우에도 위식도역류질환의 내시경적 중 증도가 높은 그룹에 속할 확률이 높았다.
Abstract
Background: There are many reports that obesity could be associated with gastoesophageal refl ux disease (GERD) but the outcomes are controversial and the studies on correlation between endoscopic severity of GERD and obesity are rare. Therefore, we investigated the association between endoscopic severity of GERD and indexes of obesity. Methods: Among the subjects who visited a health promotion center of a general hospital from January 2007 to March 2008, a total of 527 subjects with typical symptoms of GERD who underwent esophagogastroduodenoscopy and analysis of body composition were enrolled. The endoscopic severity of GERD was classifi ed depending on LA grading classifi cation system. Results: Among 527 subjects, 125 subjects were classifi ed with Non-erosive refl ux disease (NERD) while 254, 105, and 43 subjects were classifi ed as LA grade A, B, and C group, respectively. Men and frequent alcohol drinkers (≥ 5 times/week) were likely to be in higher endoscopic severity group (OR, 2.065 and 2.394, respectively; P < 0.05). If the subject was obese by BMI and waist circumference, it showed a higher possibility of belonging to the higher endoscopic severity group (OR, 2.319 and 2.596, respectively; P < 0.001). In the case of %body fat, the obesity group was more likely to be in the higher endoscopic severity group only in men (OR, 1.906; P < 0.001). Conclusion: Indexes of obesity such as BMI, %body fat (only in men), and waist circumference were related with endoscopic severity of GERD and this relationship is more apparent in men and alcohol drinkers (≥ 5 times/week).
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