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Body mass index and gastroesophageal reflux disease: a systematic review and meta-analysis.

Abstract

BACKGROUND

Gastroesophageal reflux disease (GERD) is a common cause of morbidity and health-care utilization in many countries. Obesity is a potentially modifiable risk factor, but existing studies have conflicting results, possibly due to differences in study design, definitions, or populations.

METHODS

We performed a systematic review and meta-analysis of studies identified using MEDLINE, the Web of Science electronic database, manual literature review, and a review of expert bibliographies. Studies were included if they: (1) evaluated obesity, body mass index (BMI), or another measure of body size; (2) included data on reflux symptoms, esophagitis, or a GERD-related hospitalization; and (3) reported a relative risk or odds ratio (OR) with confidence intervals or provided sufficient data to permit their calculation.

RESULTS

We identified 20 studies that included 18,346 patients with GERD. Studies from the United States demonstrated an association between increasing BMI and the presence of GERD (95% confidence interval [CI]= 1.36-1.80, overweight, OR = 1.57, P value homogeneity = 0.51, 95% CI = 1.89-2.45, obese, OR = 2.15, P= 0.10). Studies from Europe provided heterogeneous results despite stratification for several factors; individual studies demonstrated both positive associations and no association.

CONCLUSIONS

This analysis demonstrates a positive association between increasing BMI and the presence of GERD within the United States; this relationship became apparent only after stratification by country and level of BMI. These results support the evaluation of weight reduction as a potential therapy for GERD. Further studies are needed to evaluate potential mechanisms and any differences in this relationship among different study populations.

Links

  • Publisher Full Text
  • Authors+Show Affiliations

    ,

    Kaiser Permanente, Northern California, Division of Research, Oakland, California 94612, USA.

    Source

    The American journal of gastroenterology 101:11 2006 Nov pg 2619-28

    MeSH

    Body Mass Index
    Gastroesophageal Reflux
    Humans
    Obesity

    Pub Type(s)

    Journal Article
    Meta-Analysis
    Research Support, N.I.H., Extramural
    Review
    Systematic Review

    Language

    eng

    PubMed ID

    16952280

    Citation

    Corley, Douglas A., and Ai Kubo. "Body Mass Index and Gastroesophageal Reflux Disease: a Systematic Review and Meta-analysis." The American Journal of Gastroenterology, vol. 101, no. 11, 2006, pp. 2619-28.
    Corley DA, Kubo A. Body mass index and gastroesophageal reflux disease: a systematic review and meta-analysis. Am J Gastroenterol. 2006;101(11):2619-28.
    Corley, D. A., & Kubo, A. (2006). Body mass index and gastroesophageal reflux disease: a systematic review and meta-analysis. The American Journal of Gastroenterology, 101(11), pp. 2619-28.
    Corley DA, Kubo A. Body Mass Index and Gastroesophageal Reflux Disease: a Systematic Review and Meta-analysis. Am J Gastroenterol. 2006;101(11):2619-28. PubMed PMID: 16952280.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Body mass index and gastroesophageal reflux disease: a systematic review and meta-analysis. AU - Corley,Douglas A, AU - Kubo,Ai, Y1 - 2006/09/04/ PY - 2006/9/6/pubmed PY - 2006/12/13/medline PY - 2006/9/6/entrez SP - 2619 EP - 28 JF - The American journal of gastroenterology JO - Am. J. Gastroenterol. VL - 101 IS - 11 N2 - BACKGROUND: Gastroesophageal reflux disease (GERD) is a common cause of morbidity and health-care utilization in many countries. Obesity is a potentially modifiable risk factor, but existing studies have conflicting results, possibly due to differences in study design, definitions, or populations. METHODS: We performed a systematic review and meta-analysis of studies identified using MEDLINE, the Web of Science electronic database, manual literature review, and a review of expert bibliographies. Studies were included if they: (1) evaluated obesity, body mass index (BMI), or another measure of body size; (2) included data on reflux symptoms, esophagitis, or a GERD-related hospitalization; and (3) reported a relative risk or odds ratio (OR) with confidence intervals or provided sufficient data to permit their calculation. RESULTS: We identified 20 studies that included 18,346 patients with GERD. Studies from the United States demonstrated an association between increasing BMI and the presence of GERD (95% confidence interval [CI]= 1.36-1.80, overweight, OR = 1.57, P value homogeneity = 0.51, 95% CI = 1.89-2.45, obese, OR = 2.15, P= 0.10). Studies from Europe provided heterogeneous results despite stratification for several factors; individual studies demonstrated both positive associations and no association. CONCLUSIONS: This analysis demonstrates a positive association between increasing BMI and the presence of GERD within the United States; this relationship became apparent only after stratification by country and level of BMI. These results support the evaluation of weight reduction as a potential therapy for GERD. Further studies are needed to evaluate potential mechanisms and any differences in this relationship among different study populations. SN - 0002-9270 UR - https://www.unboundmedicine.com/medline/citation/16952280/full_citation L2 - http://Insights.ovid.com/pubmed?pmid=16952280 DB - PRIME DP - Unbound Medicine ER -