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Obesity and gastroesophageal reflux: quantifying the association between body mass index, esophageal acid exposure, and lower esophageal sphincter status in a large series of patients with reflux symptoms.
J Gastrointest Surg 2009; 13(8):1440-7JG

Abstract

INTRODUCTION

Obesity and gastroesophageal reflux disease (GERD) are increasingly important health problems. Previous studies of the relationship between obesity and GERD focus on indirect manifestations of GERD. Little is known about the association between obesity and objectively measured esophageal acid exposure. The aim of this study is to quantify the relationship between body mass index (BMI) and 24-h esophageal pH measurements and the status of the lower esophageal sphincter (LES) in patients with reflux symptoms.

METHODS

Data of 1,659 patients (50% male, mean age 51 +/- 14) referred for assessment of GERD symptoms between 1998 and 2008 were analyzed. These subjects underwent 24-h pH monitoring off medication and esophageal manometry. The relationship of BMI to 24-h esophageal pH measurements and LES status was studied using linear regression and multiple regression analysis. The difference of each acid exposure component was also assessed among four BMI subgroups (underweight, normal weight, overweight, and obese) using analysis of variance and covariance.

RESULTS

Increasing BMI was positively correlated with increasing esophageal acid exposure (adjusted R (2) = 0.13 for the composite pH score). The prevalence of a defective LES was higher in patients with higher BMI (p < 0.0001). Compared to patients with normal weight, obese patients are more than twice as likely to have a mechanically defective LES [OR = 2.12(1.63-2.75)].

CONCLUSION

An increase in body mass index is associated with an increase in esophageal acid exposure, whether BMI was examined as a continuous or as a categorical variable; 13% of the variation in esophageal acid exposure may be attributable to variation in BMI.

Authors+Show Affiliations

Department of Surgery, Keck School of Medicine, University of Southern California, 1510 San Pablo St, Ste 514, Los Angeles, CA 90033, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

19475461

Citation

Ayazi, Shahin, et al. "Obesity and Gastroesophageal Reflux: Quantifying the Association Between Body Mass Index, Esophageal Acid Exposure, and Lower Esophageal Sphincter Status in a Large Series of Patients With Reflux Symptoms." Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract, vol. 13, no. 8, 2009, pp. 1440-7.
Ayazi S, Hagen JA, Chan LS, et al. Obesity and gastroesophageal reflux: quantifying the association between body mass index, esophageal acid exposure, and lower esophageal sphincter status in a large series of patients with reflux symptoms. J Gastrointest Surg. 2009;13(8):1440-7.
Ayazi, S., Hagen, J. A., Chan, L. S., DeMeester, S. R., Lin, M. W., Ayazi, A., ... Crookes, P. F. (2009). Obesity and gastroesophageal reflux: quantifying the association between body mass index, esophageal acid exposure, and lower esophageal sphincter status in a large series of patients with reflux symptoms. Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract, 13(8), pp. 1440-7. doi:10.1007/s11605-009-0930-7.
Ayazi S, et al. Obesity and Gastroesophageal Reflux: Quantifying the Association Between Body Mass Index, Esophageal Acid Exposure, and Lower Esophageal Sphincter Status in a Large Series of Patients With Reflux Symptoms. J Gastrointest Surg. 2009;13(8):1440-7. PubMed PMID: 19475461.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Obesity and gastroesophageal reflux: quantifying the association between body mass index, esophageal acid exposure, and lower esophageal sphincter status in a large series of patients with reflux symptoms. AU - Ayazi,Shahin, AU - Hagen,Jeffrey A, AU - Chan,Linda S, AU - DeMeester,Steven R, AU - Lin,Molly W, AU - Ayazi,Ali, AU - Leers,Jessica M, AU - Oezcelik,Arzu, AU - Banki,Farzaneh, AU - Lipham,John C, AU - DeMeester,Tom R, AU - Crookes,Peter F, Y1 - 2009/05/28/ PY - 2009/04/15/received PY - 2009/05/11/accepted PY - 2009/5/29/entrez PY - 2009/5/29/pubmed PY - 2009/11/18/medline SP - 1440 EP - 7 JF - Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract JO - J. Gastrointest. Surg. VL - 13 IS - 8 N2 - INTRODUCTION: Obesity and gastroesophageal reflux disease (GERD) are increasingly important health problems. Previous studies of the relationship between obesity and GERD focus on indirect manifestations of GERD. Little is known about the association between obesity and objectively measured esophageal acid exposure. The aim of this study is to quantify the relationship between body mass index (BMI) and 24-h esophageal pH measurements and the status of the lower esophageal sphincter (LES) in patients with reflux symptoms. METHODS: Data of 1,659 patients (50% male, mean age 51 +/- 14) referred for assessment of GERD symptoms between 1998 and 2008 were analyzed. These subjects underwent 24-h pH monitoring off medication and esophageal manometry. The relationship of BMI to 24-h esophageal pH measurements and LES status was studied using linear regression and multiple regression analysis. The difference of each acid exposure component was also assessed among four BMI subgroups (underweight, normal weight, overweight, and obese) using analysis of variance and covariance. RESULTS: Increasing BMI was positively correlated with increasing esophageal acid exposure (adjusted R (2) = 0.13 for the composite pH score). The prevalence of a defective LES was higher in patients with higher BMI (p < 0.0001). Compared to patients with normal weight, obese patients are more than twice as likely to have a mechanically defective LES [OR = 2.12(1.63-2.75)]. CONCLUSION: An increase in body mass index is associated with an increase in esophageal acid exposure, whether BMI was examined as a continuous or as a categorical variable; 13% of the variation in esophageal acid exposure may be attributable to variation in BMI. SN - 1873-4626 UR - https://www.unboundmedicine.com/medline/citation/19475461/Obesity_and_gastroesophageal_reflux:_quantifying_the_association_between_body_mass_index_esophageal_acid_exposure_and_lower_esophageal_sphincter_status_in_a_large_series_of_patients_with_reflux_symptoms_ L2 - https://dx.doi.org/10.1007/s11605-009-0930-7 DB - PRIME DP - Unbound Medicine ER -