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Yu C, Wang T, Gao Y, Jiao Y, Jiang H, Bian Y, Wang W, Lin H, Xin L, Wang L. Association between physical activity and risk of gastroesophageal reflux disease: A systematic review and meta-analysis. JOURNAL OF SPORT AND HEALTH SCIENCE 2024; 13:687-698. [PMID: 38552714 DOI: 10.1016/j.jshs.2024.03.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 01/02/2024] [Accepted: 02/07/2024] [Indexed: 04/13/2024]
Abstract
BACKGROUND Lifestyle plays an important role in preventing and managing gastroesophageal reflux disease (GERD). In response to the conflicting results in previous studies, we performed a systematic review and meta-analysis to investigate this association. METHODS Relevant studies published until January 2023 were retrieved from 6 databases, and the prevalence of symptomatic gastroesophageal reflux (GER) or GERD was determined from the original studies. A random effects model was employed to meta-analyze the association by computing the pooled relative risk (RR) with 95% confidence intervals (95%CIs). Furthermore, subgroup and dose-response analyses were performed to explore subgroup differences and the association between cumulative physical activity (PA) time and GERD. RESULTS This meta-analysis included 33 studies comprising 242,850 participants. A significant negative association was observed between PA and the prevalence of symptomatic GER (RR = 0.74, 95%CI: 0.66-0.83; p < 0.01) or GERD (RR = 0.80, 95%CI: 0.76-0.84; p < 0.01), suggesting that engaging in PA might confer a protective benefit against GERD. Subgroup analyses consistently indicated the presence of this association across nearly all subgroups, particularly among the older individuals (RR<40 years:RR≥40 years = 0.85:0.69, p < 0.01) and smokers (RRsmoker:RRnon-smoker = 0.67:0.82, p = 0.03). Furthermore, a dose-response analysis revealed that individuals who engaged in 150 min of PA per week had a 72.09% lower risk of developing GERD. CONCLUSION Maintaining high levels of PA decreased the risk of GERD, particularly among older adults and smokers. Meeting the recommended PA level of 150 min per week may significantly decrease the prevalence of GERD.
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Affiliation(s)
- Chuting Yu
- Department of Gastroenterology, Changhai Hospital, Naval Medical University, Shanghai 200433, China; National Clinical Research Center for Digestive Diseases (Shanghai), Shanghai 200433, China
| | - Tinglu Wang
- Department of Gastroenterology, Changhai Hospital, Naval Medical University, Shanghai 200433, China; National Clinical Research Center for Digestive Diseases (Shanghai), Shanghai 200433, China
| | - Ye Gao
- Department of Gastroenterology, Changhai Hospital, Naval Medical University, Shanghai 200433, China; National Clinical Research Center for Digestive Diseases (Shanghai), Shanghai 200433, China
| | - Yunfei Jiao
- Department of Gastroenterology, Changhai Hospital, Naval Medical University, Shanghai 200433, China; National Clinical Research Center for Digestive Diseases (Shanghai), Shanghai 200433, China
| | - Huishan Jiang
- Department of Gastroenterology, Changhai Hospital, Naval Medical University, Shanghai 200433, China; National Clinical Research Center for Digestive Diseases (Shanghai), Shanghai 200433, China
| | - Yan Bian
- Department of Gastroenterology, Changhai Hospital, Naval Medical University, Shanghai 200433, China; National Clinical Research Center for Digestive Diseases (Shanghai), Shanghai 200433, China
| | - Wei Wang
- Department of Gastroenterology, Changhai Hospital, Naval Medical University, Shanghai 200433, China; National Clinical Research Center for Digestive Diseases (Shanghai), Shanghai 200433, China
| | - Han Lin
- Department of Gastroenterology, Changhai Hospital, Naval Medical University, Shanghai 200433, China; National Clinical Research Center for Digestive Diseases (Shanghai), Shanghai 200433, China
| | - Lei Xin
- Department of Gastroenterology, Changhai Hospital, Naval Medical University, Shanghai 200433, China; National Clinical Research Center for Digestive Diseases (Shanghai), Shanghai 200433, China.
| | - Luowei Wang
- Department of Gastroenterology, Changhai Hospital, Naval Medical University, Shanghai 200433, China; National Clinical Research Center for Digestive Diseases (Shanghai), Shanghai 200433, China.
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Abed MT, Sayyed E, Yamak O, Abdoh Q, Badrasawi M. The association between night eating syndrome and GERD symptoms among university students at An-Najah National University in Palestine: a cross-sectional study. BMC Gastroenterol 2024; 24:169. [PMID: 38760691 PMCID: PMC11100070 DOI: 10.1186/s12876-024-03259-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/01/2024] [Accepted: 05/08/2024] [Indexed: 05/19/2024] Open
Abstract
BACKGROUND Night eating syndrome (NES) is a kind of eating disorder. NES association with gastroesophageal reflux disease (GERD) symptoms among university students is still not fully understood. We aimed to determine the relationship between NES and the presence of GERD symptoms among university students at An-Najah National University in Palestine. METHODS This study involved undergraduate students from An-Najah National University. The data were collected through online surveys from November to December 2023. The sampling frame involved voluntary sampling, as the data were collected using a structured questionnaire to collect data on sociodemographic variables, medical history, lifestyle habits, nutritional status, GERD risk, and NES. The GERD questionnaire (GerdQ) was used to assess symptoms, while the Arabic version of the validated Night Eating Questionnaire (NEQ) was used to assess night eating. Physical activity was assessed using the short form of the International Physical Activity Questionnaire (SF-IPAQ), and adherence to a Mediterranean diet was assessed using the validated Arabic version of the MEDAS. Both univariate and multivariate analyses were also conducted to assess the study hypotheses. RESULTS The study involved 554 participants, 59.9% female. A total of 33.4% reported GERD symptoms, with 10.3% having NES. A strong association was observed between GERD and NES and between GERD and physical activity. Night eating syndrome (AOR = 2.84, CI = 1.07-3.19), high physical activity (AOR = 0.473, CI = 1.05-3.19), and non-smoking (AOR = 0.586, CI = 1.27-7.89) were identified as independent predictors of GERD symptoms. CONCLUSION This study revealed that 33.4% of undergraduate students were at risk of GERD, with night eaters having a greater risk. GERD risk was negatively associated with physical activity level and smoking status. No associations were found between GERD risk and weight status, Mediterranean diet adherence, sociodemographic factors, or sleep disturbances.
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Affiliation(s)
- Mohammad Taleb Abed
- Department of Medicine, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839, Palestine
| | - Eyad Sayyed
- Department of Medicine, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839, Palestine
| | - Obada Yamak
- Department of Medicine, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839, Palestine
| | - Qusay Abdoh
- Department of Medicine, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839, Palestine
- Department of Internal Medicine, GI and Endoscopy Unit, An-Najah National University Hospital, Nablus, 44839, Palestine
| | - Manal Badrasawi
- Department of Nutrition and Food Technology, College of Medicine and Health Sciences, An- Najah National University, Nablus, 44839, Palestine.
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Liu YX, Yang WT, Li Y. Different effects of 24 dietary intakes on gastroesophageal reflux disease: A mendelian randomization. World J Clin Cases 2024; 12:2370-2381. [PMID: 38765751 PMCID: PMC11099402 DOI: 10.12998/wjcc.v12.i14.2370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Revised: 02/11/2024] [Accepted: 04/02/2024] [Indexed: 04/29/2024] Open
Abstract
BACKGROUND In observational studies, dietary intakes are associated with gastroesophageal reflux disease (GERD). AIM To conduct a two-sample mendelian randomization (MR) analysis to determine whether those associations are causal. METHODS To explore the relationship between dietary intake and the risk of GERD, we extracted appropriate single nucleotide polymorphisms from genome-wide association study data on 24 dietary intakes. Three methods were adopted for data analysis: Inverse variance weighting, weighted median methods, and MR-Egger's method. The odds ratio (OR) and 95% confidence interval (CI) were used to evaluate the causal association between dietary intake and GERD. RESULTS Our univariate Mendelian randomization (UVMR) results showed significant evidence that pork intake (OR, 2.83; 95%CI: 1.76-4.55; P = 1.84 × 10-5), beer intake (OR, 2.70, 95%CI: 2.00-3.64; P = 6.54 × 10-11), non-oily fish intake (OR, 2.41; 95%CI: 1.49-3.91; P = 3.59 × 10-4) have a protective effect on GERD. In addition, dried fruit intake (OR, 0.37; 95%CI: 0.27-0.50; 6.27 × 10-11), red wine intake (OR, 0.34; 95%CI: 0.25-0.47; P = 1.90 × 10-11), cheese intake (OR, 0.46; 95%CI: 0.39-0.55; P =3.73 × 10-19), bread intake (OR, 0.72; 95%CI: 0.56-0.92; P = 0.0009) and cereal intake (OR, 0.45; 95%CI: 0.36-0.57; P = 2.07 × 10-11) were negatively associated with the risk of GERD. There was a suggestive association for genetically predicted coffee intake (OR per one SD increase, 1.22, 95%CI: 1.03-1.44; P = 0.019). Multivariate Mendelian randomization further confirmed that dried fruit intake, red wine intake, cheese intake, and cereal intake directly affected GERD. In contrast, the impact of pork intake, beer intake, non-oily fish intake, and bread intake on GERD was partly driven by the common risk factors for GERD. However, after adjusting for all four elements, there was no longer a suggestive association between coffee intake and GERD. CONCLUSION This study provides MR evidence to support the causal relationship between a broad range of dietary intake and GERD, providing new insights for the treatment and prevention of GERD.
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Affiliation(s)
- Yu-Xin Liu
- Department of Oncology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu 610072, Sichuan Province, China
| | - Wen-Tao Yang
- Department of Cardiovascular, Chengdu Integrated TCM & Western Medicine Hospital, Chengdu 610041, Sichuan Province, China
| | - Yang Li
- Department of Nuclear Medicine, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu 610072, Sichuan Province, China
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Hungin AP, Yadlapati R, Anastasiou F, Bredenoord AJ, El Serag H, Fracasso P, Mendive JM, Savarino EV, Sifrim D, Udrescu M, Kahrilas PJ. Management advice for patients with reflux-like symptoms: an evidence-based consensus. Eur J Gastroenterol Hepatol 2024; 36:13-25. [PMID: 38006602 PMCID: PMC10695341 DOI: 10.1097/meg.0000000000002682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 10/11/2023] [Indexed: 11/27/2023]
Abstract
Patients with reflux-like symptoms (heartburn and regurgitation) are often not well advised on implementing individualised strategies to help control their symptoms using dietary changes, lifestyle modifications, behavioural changes or fast-acting rescue therapies. One reason for this may be the lack of emphasis in management guidelines owing to 'low-quality' evidence and a paucity of interventional studies. Thus, a panel of 11 gastroenterologists and primary care doctors used the Delphi method to develop consolidated advice for patients based on expert consensus. A steering committee selected topics for literature searches using the PubMed database, and a modified Delphi process including two online meetings and two rounds of voting was conducted to generate consensus statements based on prespecified criteria (67% voting 'strongly agree' or 'agree with minor reservation'). After expert discussion and two rounds of voting, 21 consensus statements were generated, and assigned strength of evidence and Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) rating. Eleven statements achieved the strongest (100%) agreement: five are related to diet and include identification and avoidance of dietary triggers, limiting alcohol, coffee and carbonated beverages, and advising patients troubled by postprandial symptoms not to overeat; the remaining six statements concern advice around smoking cessation, weight loss, raising the head-of-the-bed, avoiding recumbency after meals, stress reduction and alginate use. The aim of developing the consensus statements is that they may serve as a foundation for tools and advice that can routinely help patients with reflux-like symptoms better understand the causes of their symptoms and manage their individual risk factors and triggers.
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Affiliation(s)
- A. Pali Hungin
- Professor Emeritus, Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Rena Yadlapati
- Division of Gastroenterology, University of California San Diego, La Jolla, California, USA
| | - Foteini Anastasiou
- 4th Local Primary Care Team, Municipality Practice and Academic Practice of Heraklion; University of Crete, Crete, Greece
| | - Albert J. Bredenoord
- Department of Gastroenterology, Amsterdam University Medical Centers, Amsterdam, the Netherlands
| | - Hashem El Serag
- Department of Medicine, Baylor College of Medicine, Houston, Texas, USA
| | - Pierluigi Fracasso
- Department of Gastroenterology and Digestive Endoscopy, Ospedale Sandro Pertini, Local Health Agency Roma 2, Rome, Italy
| | - Juan M Mendive
- La Mina Primary Care Academic Centre, Catalan Health Institute, University of Barcelona, Spain
| | - Edoardo V. Savarino
- Department of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy
| | - Daniel Sifrim
- Wingate Institute of Neurogastroenterology, Queen Mary University of London, London, UK
| | | | - Peter J Kahrilas
- Division of Gastroenterology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
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Quach DT, Luu MN, Nguyen PV, Vo UPP, Vo CHM. Dietary and lifestyle factors associated with troublesome gastroesophageal reflux symptoms in Vietnamese adults. Front Nutr 2023; 10:1280511. [PMID: 38024385 PMCID: PMC10663327 DOI: 10.3389/fnut.2023.1280511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 10/25/2023] [Indexed: 12/01/2023] Open
Abstract
Background Dietary and lifestyle habits related to troublesome gastroesophageal reflux symptoms (tGERS) differ significantly across populations. There have yet to be studies on the Vietnamese population. Aims To identify dietary and lifestyle habits associated with tGERS in Vietnamese adults. Methods A cross-sectional survey was conducted among Vietnamese adults aged 18 years and older from March 2023 to May 2023. Participants were recruited online through a widely read national newspaper and Facebook, one of Vietnam's most popular social media platforms. The survey questionnaire comprised 27 questions covering participants' basic demographic information, dietary and lifestyle habits, the presence and characteristics of tGERS, and inquiries about specific dietary and lifestyle patterns, foods, and beverages associated with tGERS. Results A total of 4,400 valid responses were collected, including 2050 participants without tGERS and 2,350 participants with tGERS. Multivariate analysis showed several factors associated with tGERS, including eating beyond fullness (OR 1.383, CI95% 1.127-1.698), tight clothing (OR 1.627, CI95% 1.256-2.107), stress (OR 1.566, CI95% 1.363-1.800), and insomnia (OR 1.321, CI95% 1.129-1.546). Among habits associated with tGERS, eating beyond fullness was the most frequently reported (64.6%). Interestingly, although a short meal-to-bed time and staying up late after midnight were not risk factors for tGERS, they were two common factors associated with tGERS in symptomatic participants, particularly those with nocturnal reflux symptoms. For food triggers, the three most common ones were greasy foods (71.9%), sour/spicy soups (64.7%), and citrus fruits (36.0%). In terms of beverages, carbonated soft drinks were at the top of triggering tGERS (40.3%), and beer and orange juice were the second and third most common triggers, accounting for 35.7 and 30.6%, respectively. Conclusion We reported the dietary and lifestyle habits associated with tGERS in Vietnamese adults for the first time. These findings will serve as a basis for future studies on the primary prevention and nondrug management of tGERS in Vietnam.
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Affiliation(s)
- Duc Trong Quach
- Department of Internal Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
- Department of Gastroenterology, Nhan Dan Gia Dinh Hospital, Ho Chi Minh City, Vietnam
| | - Mai Ngoc Luu
- Department of Internal Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
- Department of Gastroenterology, Nhan Dan Gia Dinh Hospital, Ho Chi Minh City, Vietnam
| | - Phong Van Nguyen
- Department of Gastroenterology, Nhan Dan Gia Dinh Hospital, Ho Chi Minh City, Vietnam
| | - Uyen Pham-Phuong Vo
- Department of Internal Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
- Department of Gastroenterology, Nhan Dan Gia Dinh Hospital, Ho Chi Minh City, Vietnam
| | - Cong Hong-Minh Vo
- Department of Gastroenterology, Nhan Dan Gia Dinh Hospital, Ho Chi Minh City, Vietnam
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Aili A, Maimaitiming M, Li Y, Maisiyiti A, Wang Z, Tusuntuoheti Y, Abudureyimu K. Laparoscopic hiatal hernia repair for treating patients with massive hiatal hernia and iron-deficiency anaemia. BMC Surg 2023; 23:293. [PMID: 37752453 PMCID: PMC10521551 DOI: 10.1186/s12893-023-02184-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 09/04/2023] [Indexed: 09/28/2023] Open
Abstract
BACKGROUND Massive hiatal hernias may result in extraoesophageal symptoms, including iron-deficiency anaemia. However, the role played by hiatal hernias in iron-deficiency anaemia is not clearly understood. We examined the prevalence of anaemia in patients with massive hiatal hernias and the frequency of anaemia resolution after laparoscopic hiatal hernia repair at long term follow-up. METHODS Patients who underwent laparoscopic hiatal hernia repair from June 2008 to June 2019 were enrolled in this study. We collected the patients' demographic and clinical data from their medical records, and compared the pre-surgical and post-surgical findings (at 1 week and 3 months post-surgery). All patients with adequate documentation underwent post-surgical follow-up to evaluate improvements in clinical symptoms and signs. RESULTS A total of 126 patients with massive hiatal hernias underwent laparoscopic hiatal hernia repair. Of these, 35 (27.8%) had iron-deficiency anaemia. Anaemia was resolution in all the patients and they had significantly reduced GERD-Q scores at 3 months postoperatively (P<0.01) .The mean follow-up period was 60 months. Iron-deficiency anaemia resolution after hiatal hernia repair was achieved in 93.9% of the patients. CONCLUSION Anaemia is common in patients with massive hiatal hernias, and most of our patients were symptomatic because of their anaemia. Moreover, in patients with massive hiatal hernias, iron-deficiency anaemia resolution is likely after laparoscopic hiatal hernia repair.
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Affiliation(s)
- Aikebaier Aili
- Department of Minimally Invasive Surgery, Hernias and Abdominal Wall Surgery, People's Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Uygur Autonomous Region, Urumqi, China
- Xinjiang Clinical Research Center for Gastroesophageal Reflux Disease and Bariatric Metabolic Surgery, Xinjiang Uygur Autonomous Region, Urumqi, China
- Research Institute of General and Minimally Invasive Surgery, Xinjiang Uygur Autonomous Region, Xinjiang Uygur Autonomous Region, Urumqi, China
| | - Maimaitiaili Maimaitiming
- Department of Minimally Invasive Surgery, Hernias and Abdominal Wall Surgery, People's Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Uygur Autonomous Region, Urumqi, China
- Xinjiang Clinical Research Center for Gastroesophageal Reflux Disease and Bariatric Metabolic Surgery, Xinjiang Uygur Autonomous Region, Urumqi, China
- Research Institute of General and Minimally Invasive Surgery, Xinjiang Uygur Autonomous Region, Xinjiang Uygur Autonomous Region, Urumqi, China
| | - Yiliang Li
- Department of Minimally Invasive Surgery, Hernias and Abdominal Wall Surgery, People's Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Uygur Autonomous Region, Urumqi, China
- Xinjiang Clinical Research Center for Gastroesophageal Reflux Disease and Bariatric Metabolic Surgery, Xinjiang Uygur Autonomous Region, Urumqi, China
- Research Institute of General and Minimally Invasive Surgery, Xinjiang Uygur Autonomous Region, Xinjiang Uygur Autonomous Region, Urumqi, China
| | - Alimujiang Maisiyiti
- Department of Minimally Invasive Surgery, Hernias and Abdominal Wall Surgery, People's Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Uygur Autonomous Region, Urumqi, China
- Xinjiang Clinical Research Center for Gastroesophageal Reflux Disease and Bariatric Metabolic Surgery, Xinjiang Uygur Autonomous Region, Urumqi, China
- Research Institute of General and Minimally Invasive Surgery, Xinjiang Uygur Autonomous Region, Xinjiang Uygur Autonomous Region, Urumqi, China
| | - Zhi Wang
- Department of Minimally Invasive Surgery, Hernias and Abdominal Wall Surgery, People's Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Uygur Autonomous Region, Urumqi, China
- Xinjiang Clinical Research Center for Gastroesophageal Reflux Disease and Bariatric Metabolic Surgery, Xinjiang Uygur Autonomous Region, Urumqi, China
- Research Institute of General and Minimally Invasive Surgery, Xinjiang Uygur Autonomous Region, Xinjiang Uygur Autonomous Region, Urumqi, China
| | - Yusujiang Tusuntuoheti
- The graduate student institute of Xinjiang Medical University, Urumqi, Xinjiang Uygur Autonomous Region, China
| | - Kelimu Abudureyimu
- Department of Minimally Invasive Surgery, Hernias and Abdominal Wall Surgery, People's Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Uygur Autonomous Region, Urumqi, China.
- Xinjiang Clinical Research Center for Gastroesophageal Reflux Disease and Bariatric Metabolic Surgery, Xinjiang Uygur Autonomous Region, Urumqi, China.
- Research Institute of General and Minimally Invasive Surgery, Xinjiang Uygur Autonomous Region, Xinjiang Uygur Autonomous Region, Urumqi, China.
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Zheng Y, Dong J, Yang X, Shuai P, Li Y, Li H, Dong S, Gong Y, Liu M, Zeng Q. Benign-malignant classification of pulmonary nodules by low-dose spiral computerized tomography and clinical data with machine learning in opportunistic screening. Cancer Med 2023. [PMID: 37248730 DOI: 10.1002/cam4.5886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 03/14/2023] [Accepted: 03/19/2023] [Indexed: 05/31/2023] Open
Abstract
BACKGROUND Many people were found with pulmonary nodules during physical examinations. It is of great practical significance to discriminate benign and malignant nodules by using data mining technology. METHODS The subjects' demographic data, baseline examination results, and annual follow-up low-dose spiral computerized tomography (LDCT) results were recorded. The findings from annual physical examinations of positive nodules, including highly suspicious nodules and clinically tentative benign nodules, was analyzed. The extreme gradient boosting (XGBoost) model was constructed and the Grid Search CV method was used to select the super parameters. External unit data were used as an external validation set to evaluate the generalization performance of the model. RESULTS A total of 135,503 physical examinees were enrolled. Baseline testing found that 27,636 (20.40%) participants had clinically tentative benign nodules and 611 (0.45%) participants had highly suspicious nodules. The proportion of highly suspicious nodules in participants with negative baseline was about 0.12%-0.46%, which was lower than the baseline level except the follow-up of >5 years. In the 27,636 participants with clinically tentative benign nodules, only in the first year of LDCT re-examination was the proportion of highly suspicious nodules (1.40%) significantly greater than that of baseline screening (0.45%) (p < 0.001), and the proportion of highly suspicious nodules was not different between the baseline screening and other follow-up years (p > 0.05). Furthermore, 322 cases with benign nodules and 196 patients with malignant nodules confirmed by surgery and pathology were compared. A model and the top 15 most important clinical variables were determined by XGBoost algorithm. The area under the curve (AUC) of the model was 0.76 [95% CI: 0.67-0.84], and the accuracy was 0.75. The sensitivity and specificity of the model under this threshold were 0.78 and 0.73, respectively. In the validation of model using external data, the AUC was 0.87 and the accuracy was 0.80. The sensitivity and specificity were 0.83 and 0.77, respectively. CONCLUSIONS It is important that pulmonary nodules could be more accurately identified at the first LDCT examination. A model with 15 variables which are routinely measured in the clinic could be helpful to distinguish benign and malignant nodules. It could help the radiological team issue a more accurate report; and it may guide the clinical team regarding LDCT follow-up.
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Affiliation(s)
- Yansong Zheng
- Department of Health Medicine, Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese People's Liberation Army General Hospital, Beijing, China
| | - Jing Dong
- Research of Medical Big Data Center & National Engineering Laboratory for Medical Big Data Application Technology, Chinese PLA General Hospital, Beijing, China
| | - Xue Yang
- Department of Health Medicine, Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese People's Liberation Army General Hospital, Beijing, China
| | - Ping Shuai
- Health Management Center, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Yongli Li
- Department of Health Management/ Henan Provincial People's Hospital of Zhengzhou University, Henan Key Laboratory of Chronic Disease Management, Zhengzhou, China
| | - Hailin Li
- Beijing Advanced Innovation Center for Big Data-Based Precision Medicine, School of Medicine and Engineering, Beihang University, Beijing, China
- CAS Key Laboratory of Molecular Imaging, Institute of Automation, Beijing, China
| | - Shengyong Dong
- Department of Health Medicine, Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese People's Liberation Army General Hospital, Beijing, China
| | - Yan Gong
- Department of Health Medicine, Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese People's Liberation Army General Hospital, Beijing, China
| | - Miao Liu
- Graduate School, Chinese PLA general hospital, Beijing, China
| | - Qiang Zeng
- Department of Health Medicine, Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese People's Liberation Army General Hospital, Beijing, China
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Belete M, Tesfaye W, Akalu Y, Adane A, Yeshaw Y. Gastroesophageal reflux disease symptoms and associated factors among university students in Amhara region, Ethiopia, 2021: a cross-sectional study. BMC Gastroenterol 2023; 23:130. [PMID: 37076820 PMCID: PMC10116815 DOI: 10.1186/s12876-023-02758-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 04/06/2023] [Indexed: 04/21/2023] Open
Abstract
INTRODUCTION Gastroesophageal reflux disease (GERD) symptom is a relapsing chronic medical condition resulting from the reflux of gastric acid contents into the esophagus and throat or mouth. It interferes with social functioning, sleep, productivity, and quality of life. Despite this, the magnitude of GERD symptoms is not known in Ethiopia. Therefore, this study was conducted to determine the prevalence and associated factors of GERD symptoms among university students in the Amhara national regional state. METHODS An institutional-based cross-sectional study was employed in Amhara national regional state Universities, from April 1, 2021, to May 1, 2021. Eight hundred and forty-six students were included in the study. A stratified multistage sampling technique was employed. Data were collected by using a pretested self-administered questionnaire. Data were entered via Epi Data version 4.6.0.5 and analyzed by SPSS version-26 software. The bivariable and multivariable binary logistic regression analyses were used to determine the associated factors of GERD symptoms. The adjusted odds ratio (AOR) with a 95% confidence interval (CI) was calculated. Variables having a p-value of ≤ 0.05 were considered statistically significant. RESULTS The prevalence of GERD symptoms in this study was 32.1% (95% CI = 28.7-35.5%). Being in the age of 20-25 years (AOR = 1.74, 95%CI = 1.03-2.94), female (AOR = 1.67, 95% CI = 1.15-2.41), use of antipain (AOR = 2.47, 95% CI = 1.65-3.69) and soft drinks (AOR = 1.58, 95% CI = 1.13-2.20) were significantly associated with higher odds of GERD symptoms. Urban dwellers had less chance of having GERD symptoms (AOR = 0.67, 95% CI = 0.48-0.94). CONCLUSION Nearly one-third of university students are affected by GERD symptoms. Age, sex, residence, use of antipain, and consumption of soft drinks were significantly associated with GERD. Reducing modifiable risk factors such as antipain use and soft drink consumption among students is advisable to decrease the disease burden.
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Affiliation(s)
- Mekonnen Belete
- Department of Human Physiology, School of Medicine, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia.
| | - Winta Tesfaye
- Department of Human Physiology, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Yonas Akalu
- Department of Human Physiology, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Adugnaw Adane
- Department of Human Physiology, School of Medicine, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia
| | - Yigizie Yeshaw
- Department of Human Physiology, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Beigrezaei S, Sasanfar B, Nafei Z, Behniafard N, Aflatoonian M, Salehi-Abargouei A. Dietary approaches to stop hypertension (DASH)-style diet in association with gastroesophageal reflux disease in adolescents. BMC Public Health 2023; 23:358. [PMID: 36803489 PMCID: PMC9936743 DOI: 10.1186/s12889-023-15225-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Accepted: 02/06/2023] [Indexed: 02/19/2023] Open
Abstract
BACKGROUND Dietary patterns and food items have been associated with gastroesophageal reflux disease (GERD) risk and they have led to conflicting findings. The aim of this study was to determine the association between a dietary approach to stop hypertension (DASH)-style diet with the risk of GERD and its symptoms in adolescents. STUDY DESIGN Cross-sectional. METHODS This study was performed on 5,141 adolescents aged between 13 and 14 years. Dietary intake was evaluated using a food frequency method. The diagnosis of GERD was done by using a six-item GERD questionnaire that asked about GERD symptoms. A binary logistic regression was used to assess the association between the DASH-style diet score and GERD and its symptoms in crude and multivariable-adjusted models. RESULTS Our findings revealed that after adjustment for all confounding variables, the adolescents with the highest adherence to the DASH-style diet had a lower chance of developing GERD [odds ratio (OR) = 0.50; 95%CI 0.33-0.75, Ptrend< 0.001)], reflux (OR = 0.42; 95%CI 0.25-0.71, Ptrend=0.001), nausea (OR = 0.59; 95% CI:0.32-1.08, Ptrend=0.05) and stomach pain (OR = 0.69; 95%CI 0.49-0.98, P trend=0.03) compared to those with the lowest adherence. Similar results were found for odds of GERD among boys, and the total population (OR = 0.37; 95%CI: 0.18-0.73, Ptrend=0.002, OR = 0.51; 95%CI: 0.34-0.77, P trend<0.0, respectively). CONCLUSION The current study revealed that adherence to a DASH-style diet might protect against GERD and its symptoms including, reflux, nausea, and stomach pain in adolescents. Further prospective research is needed to confirm these findings.
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Affiliation(s)
- Sara Beigrezaei
- grid.412505.70000 0004 0612 5912Nutrition and Food Security Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran ,grid.412505.70000 0004 0612 5912Department of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Bahareh Sasanfar
- grid.412505.70000 0004 0612 5912Nutrition and Food Security Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran ,grid.412505.70000 0004 0612 5912Department of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Zahra Nafei
- grid.412505.70000 0004 0612 5912Children Growth Disorder Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Nasrin Behniafard
- grid.412505.70000 0004 0612 5912Children Growth Disorder Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran ,grid.412505.70000 0004 0612 5912Mother and Newborn Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Majid Aflatoonian
- Children Growth Disorder Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
| | - Amin Salehi-Abargouei
- grid.412505.70000 0004 0612 5912Nutrition and Food Security Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran ,grid.412505.70000 0004 0612 5912Department of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran ,grid.412505.70000 0004 0612 5912Yazd Cardiovascular Research Center, Non-communicable Diseases Research Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
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Liu Z, Gao X, Liang L, Zhou X, Han X, Yang T, Huang K, Lin Y, Deng S, Wang Z, Wang C. Prevalence, General and Periodontal Risk Factors of Gastroesophageal Reflux Disease in China. J Inflamm Res 2023; 16:235-244. [PMID: 36691403 PMCID: PMC9863457 DOI: 10.2147/jir.s395777] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 12/31/2022] [Indexed: 01/18/2023] Open
Abstract
Purpose There is insufficient information about the prevalence and risk factors of gastroesophageal reflux disease (GERD) in the Chinese adult population. We aimed to assess the prevalence and identify the risk factors of GERD in China. Methods We collected data from a nationally representative sample (50,991 subjects) of Chinese adults from a large nation-wide cross-sectional survey. GERD was diagnosed by a standardized Chinese-language GERD questionnaire with a score of ≥ 8. The demographic characteristics, comorbidities and periodontal factors of all participants were collected. Results Fifty-thousands-one-hundred-eighty-three participants were finally included in this study. The overall prevalence of GERD was 5.6% (95% CI, 5.4-5.8%) among the general Chinese population aged 20 years or older. Women, smokers, and people with older age, BMI ≥ 25.0 kg/m2, urban residence, lower education level or comorbidities were more prevalent with GERD (p < 0.001). Symptoms of severe periodontitis (OR = 1.40, 95% CI 1.28-1.52, p < 0.001) and lower frequency of tooth brushing (OR = 2.01, 95% CI 1.76-2.29, p < 0.001) were significantly associated with risk of GERD. Conclusion Symptom-based GERD is highly prevalent in the Chinese population. Overweight and smoking are major preventable risk factors for GERD. Periodontal factors are novel potential risk factors for GERD and should be given more attention in GERD prevention.
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Affiliation(s)
- Zhiqiang Liu
- Department of Stomatology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, People’s Republic of China
| | - Xiaoli Gao
- Department of Stomatology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, People’s Republic of China
| | - Lirong Liang
- Department of Clinical Epidemiology, Beijing Institute of Respiratory Medicine and Beijing Chao-Yang Hospital, Capital Medical University, Beijing, People’s Republic of China
| | - Xuan Zhou
- Department of Stomatology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, People’s Republic of China
| | - Xiaozhe Han
- Department of Oral Science and Translational Research, Nova Southeastern University College of Dental Medicine, Fort Lauderdale, FL, USA
| | - Ting Yang
- Department of Pulmonary and Critical Care Medicine, China-Japan Friendship Hospital, Beijing, People’s Republic of China,National Clinical Research Center for Respiratory Diseases, Beijing, People’s Republic of China,Institute of Respiratory Medicine, Peking Union Medical College, Beijing, People’s Republic of China,Department of Respiratory Medicine, Capital Medical University, Beijing, People’s Republic of China
| | - Kewu Huang
- Beijing Key Laboratory of Respiratory and Pulmonary Circulation Disorders, Department of Pulmonary and Critical Care Medicine, Beijing Chao-Yang Hospital, Beijing, People’s Republic of China
| | - Yingxiang Lin
- Beijing Key Laboratory of Respiratory and Pulmonary Circulation Disorders, Department of Pulmonary and Critical Care Medicine, Beijing Chao-Yang Hospital, Beijing, People’s Republic of China
| | - Shu Deng
- Department of Immunology and Infectious Diseases, The Forsyth Institute, Harvard School of Dental Medicine Affiliate, Cambridge, MA, USA
| | - Zuomin Wang
- Department of Stomatology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, People’s Republic of China,Correspondence: Zuomin Wang, Department of Stomatology, Beijing Chao-Yang Hospital, Capital Medical University, 8 Gongti South Road, Chaoyang District, Beijing, 100020, People’s Republic of China, Tel +86 10 85231492, Email
| | - Chen Wang
- Department of Pulmonary and Critical Care Medicine, China-Japan Friendship Hospital, Beijing, People’s Republic of China,National Clinical Research Center for Respiratory Diseases, Beijing, People’s Republic of China,Institute of Respiratory Medicine, Peking Union Medical College, Beijing, People’s Republic of China,Department of Respiratory Medicine, Capital Medical University, Beijing, People’s Republic of China,WHO Collaborating Centre for Tobacco Cessation and Respiratory Diseases Prevention, Beijing, People’s Republic of China,Chen Wang, Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, 2 Yinghuayuan Dongjie, Chaoyang District, Beijing, 100029, People’s Republic of China, Tel +86 10 65105565, Email
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11
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Wang Y, Zhou B, Fang S, Zhu S, Xu T, Dilikumaer M, Li G. Dynorphin participates in interaction between depression and non-erosive reflux disease. Esophagus 2023; 20:158-169. [PMID: 36244036 PMCID: PMC9813039 DOI: 10.1007/s10388-022-00955-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Accepted: 09/07/2022] [Indexed: 02/03/2023]
Abstract
BACKGROUND To explore the relationships between anxiety/depression and NERD, we focused on dynorphin (Dyn), an important member of visceral hypersensitivity, and its related pathways. METHODS Pearson's correlation analysis on patients with NERD and in vivo experiment on NERD rat model. Part 1: Pearson's correlation analysis among serum levels of Dyn, clinical symptoms and HADS scores of NERD patients were carried on. Part 2: Wistar rats were randomly divided into 2 groups: control group and model group. The data of pH value, immobility time, serum Dyn concentration, NMDAR1 and SP expression were, respectively, derived from automatic pH recorder, tail suspension test, enzyme-linked immunosorbent assay, immunohistochemistry and immunofluorescence. RESULTS Part 1: Pearson's correlation analysis showed that there was a linear correlation between Clinical Symptom (CS) score and HADS score (HAD-A, HAD-D), and the correlation coefficients were 0.385 and 0.273 respectively; the correlation coefficient between lg (Dyn) and lg (CS score) was r = 0.441, P = 0.002; the correlation coefficient between lg(Dyn) and lg (HAD-D score) was r = 0.447, P = 0.002. Part 2: The pH value of the lower esophagus in the model group was lower than that in the control group (P < 0.01). The tail suspension immobility time of model group was significantly longer than that of control group (P < 0.01). The serum Dyn concentration and the expression level of NMDAR1 in spinal cord and SP in lower esophageal mucosa of model group were significantly higher than those of control group (P < 0.05). CONCLUSION Increased serum dynorphin level may be a sign of correlation between depression and NERD.
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Affiliation(s)
- Yi Wang
- Department of Gastroenterology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Bingduo Zhou
- Department of Gastroenterology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Shengquan Fang
- Department of Gastroenterology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Shengliang Zhu
- Department of Gastroenterology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Tingting Xu
- Department of Gastroenterology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Makan Dilikumaer
- Department of Gastroenterology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Guanwu Li
- Department of Radiology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China.
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12
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Luo Y, Wu F, Huang Z, Gong Y, Zheng Y. Assessment of the relationship between subclinical hypothyroidism and blood lipid profile: reliable or not? Lipids Health Dis 2022; 21:137. [PMID: 36514152 PMCID: PMC9746155 DOI: 10.1186/s12944-022-01749-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 12/07/2022] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND The relationship between subclinical hypothyroidism (SCH) and blood lipid metabolism is controversial. This study is intended to evaluate the relationship between SCH and blood lipid profiles using well defined diagnostic criteria. METHODS Data from 11,512 physical examinees in our hospital who had finished two tests with an interval of at least 3 months were analyzed, including 685 cases of SCH as stipulated in this study. In addition to common physical examination indicators, other parameters such as thyroid function indices and blood lipids were measured twice with an interval of at least 3 months. Subjects were diagnosed with SCH only when their levels of TT3, TT4, FT3 and FT4 were normal and TSH levels were increased on both tests, which meant these subjects were in a state of SCH for at least 3 months. The results of blood lipids for the second time were analyzed. RESULTS Statistically significant differences were found in age, sex, BMI, hemoglobin, total cholesterol (TC), low density lipoprotein (LDL-C), high density lipoprotein (HDL-C), and BFP between the SCH and control groups (P < 0.001). However, there were no statistically significant differences in age, sex, blood pressure, blood lipids, blood glucose or BMI between patients with mild SCH and those with severe SCH (P > 0.05). After balancing the age and sex ratio, no factors were confirmed to be statistically significant independent factors of SCH. None of the parameters showed statistically significant differences between patients with mild SCH and those with severe SCH (P > 0.05). CONCLUSION After defining rigorous criteria for the diagnosis of SCH, no definite association between SCH and TC, LDL-C or HDL-C was confirmed in this study. SCH may have no relationship to the most concerning blood lipid profile.
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Affiliation(s)
- Yi Luo
- grid.414252.40000 0004 1761 8894The Department of Health Medicine, Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese People’s Liberation Army General Hospital, 28# Fuxing Road, Haidian District, Beijing, 100853 China
| | - Fei Wu
- Health Management Department of China Health Promotion Foundation, Beijing, China
| | - Zhen Huang
- grid.459785.2Health Management Center of Nanning First People’s Hospital, Nanning, China
| | - Yan Gong
- grid.414252.40000 0004 1761 8894The Department of Health Medicine, Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese People’s Liberation Army General Hospital, 28# Fuxing Road, Haidian District, Beijing, 100853 China
| | - Yansong Zheng
- grid.414252.40000 0004 1761 8894The Department of Health Medicine, Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese People’s Liberation Army General Hospital, 28# Fuxing Road, Haidian District, Beijing, 100853 China
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Zheng YS, Dong SY, Gong Y, Wang JH, Wang F, Zeng Q. Comparison of Five Different Criteria for Diagnosis of Subclinical Hypothyroidism in a Large-Scale Chinese Population. Front Endocrinol (Lausanne) 2022; 13:820414. [PMID: 35242111 PMCID: PMC8887626 DOI: 10.3389/fendo.2022.820414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Accepted: 01/20/2022] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Several different criteria for subclinical hypothyroidism (SCH) have been used in the literature, but the performance of these criteria was unknown. OBJECTIVE This retrospective study was to evaluate the diagnostic criteria for SCH. METHODS Eligible participants were based on centration of thyroglobulin antibodies (TG-Ab), thyroid peroxidase antibodies (TPO-Ab), and five thyroid-related hormones including total thyroxine (TT4), total triiodothyronine (TT3), free thyroxine (FT4), free triiodothyronine (FT3), and thyroid-stimulating hormone (TSH). Euthyroid individuals were identified via specific criteria. Five different SCH diagnostic criteria were compared based on the distributions of those indicators. An appropriate TSH cut-off value was reconsidered. RESULTS The study included 145,015 participants. The number of SCH cases diagnosed using criterion 5 was significantly different compared to the cases diagnosed using criteria 1-4 (P<0.05) and had the highest positive proportions of TG-Ab and TPO-Ab. Analysis of 60,515 subjects with normal other thyroid hormones revealed a median TSH concentration of 2.04 mIU/L, and the P 2.5-P 97.5 CI was 0.48-7.03 mIU/L. When the threshold for TSH elevation was elevated from ≥4.5 mIU/L to ≥6.50 mIU/L, the number of diagnosed SCH cases decreased from 7.30% to 2.09% and the proportions of positive TG-Ab and TPO-Ab increased from 23.69% and 24.07% to 33.75% and 35.06%, respectively (P<0.01). CONCLUSIONS Combination of an elevated TSH and normal TT3, TT4, FT3, and FT4 concentrations is a must for the diagnosis of SCH. A new TSH threshold should be identified for better patient monitoring and management, according to the real-world characteristics of TSH distribution in Chinese population.
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Tuerxun K, Balati M, Aimaiti M, Yusupu Z, Ibrahim I, Wu Y, Tuerdi M, Akemu Y, Abudoureyimu K, Tuerxun Y. Epidemiological investigation, extraesophageal symptoms and risk factors of gastroesophageal reflux disease in Kashgar, Xinjiang, China. Am J Transl Res 2021; 13:14186-14194. [PMID: 35035764 PMCID: PMC8748132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Accepted: 11/18/2021] [Indexed: 06/14/2023]
Abstract
OBJECTIVE To explore the incidence, distribution characteristics and related symptoms of gastroesophageal reflux disease (GERD) as well as its related risk factors in Kashgar, Xinjiang. METHODS From March 2020 to October 2020, a questionnaire survey was conducted among 5,080 permanent residents aged 18-80 years in Kashgar using cluster sampling and stratified sampling methods. The content included basic information, accompanying symptoms and diseases, living, customs and eating habits, and Gastroesophageal Reflux Disease Questionnaire score, etc. Results: The prevalence of GERD in Kashgar was 23.4% (1187/5080), and the proportions of patients with reflux symptoms lasting 1 day, 2-3 days and 4-7 days within a week were 12.5%, 6.4% and 4.4%, respectively. The proportion of patients showing symptoms in the GERD group was significantly higher than that in the non-GERD group (P<0.05). The proportion of people who are overweight or obese, take alcohol drink, eat, constipate, or take various chronic disease drugs in the GERD group is higher than that in the non-GERD group. The proportion of people in the GERD group who often eat sweet foods, pickled products, roasted products, spicy foods and meat, or drink coffee, acidic beverages, and cold drinks was higher than that in the non-GERD (P<0.05). The proportion of people in the GERD group who regularly consume fish, milk, eggs, vegetables, and fruits was significantly lower than that in non-GERD group (P<0.05). Logistic regression analysis found that Uyghur nationality (for the Han nationality), age (for the 30-39 years group), drinking, overeat, constipation, and frequent medication were risk factors (P<0.05, OR>1). Multivariate logistic regression analysis found that sweets, baked products, cold drinks, and spicy foods were independent risk factors (P<0.05, OR>1). Eggs and vegetables were protective factors (P<0.05, OR<1). CONCLUSION The high incidence of GRED in Kashgar, Xinjiang may be related to the local living environment, and life and eating habits.
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Affiliation(s)
- Kahaer Tuerxun
- Second Department of General Surgery, The First People’s Hospital of Kashgar PrefectureKashgar, Xinjiang, China
| | - Mutailipu Balati
- Second Department of General Surgery, The First People’s Hospital of Kashgar PrefectureKashgar, Xinjiang, China
| | - Maimaitiming Aimaiti
- First Department of General Surgery, The First People’s Hospital of Kashgar PrefectureKashgar, Xinjiang, China
| | - Zainuer Yusupu
- Ultrasound Medicine Departement, The First People’s Hospital of Kashgar PrefectureKashgar, Xinjiang, China
| | - Irxat Ibrahim
- Second Department of General Surgery, The First People’s Hospital of Kashgar PrefectureKashgar, Xinjiang, China
| | - Yuanquan Wu
- Second Department of General Surgery, The First People’s Hospital of Kashgar PrefectureKashgar, Xinjiang, China
| | - Maimaitituerxun Tuerdi
- Second Department of General Surgery, The First People’s Hospital of Kashgar PrefectureKashgar, Xinjiang, China
| | - Yusufu Akemu
- Department of Pediatric Surgery, Children’s Hospital of Xinjiang Uygur Autonomous RegionUrumqi, Xinjiang, China
| | - Kelimu Abudoureyimu
- Department of Minimal Invasive and Hernia, People’s Hospital of Xinjiang Uygur Autonomous RegionUrumqi, Xinjiang, China
| | - Yilihamujiang Tuerxun
- Second Department of General Surgery, The First People’s Hospital of Kashgar PrefectureKashgar, Xinjiang, China
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Mun E, Kim D, Lee Y, Lee W, Park S. Association between Shift Work and Reflux Esophagitis: The Kangbuk Samsung Health Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18126189. [PMID: 34201073 PMCID: PMC8227586 DOI: 10.3390/ijerph18126189] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/03/2021] [Revised: 06/06/2021] [Accepted: 06/07/2021] [Indexed: 12/12/2022]
Abstract
This cross-sectional study investigated the relationship between shift work and reflux esophagitis verified by endoscopic findings. Participants underwent a comprehensive health examination and esophagogastroduodenoscopy between January 2011 and December 2018. We examined endoscopic findings and performed multivariate-adjusted regression analysis of the association between shift work and reflux esophagitis using multiple demographic and clinical factors. Among the 247,450 participants, 49,767 (20.1%) had reflux esophagitis; Los Angeles (LA)-M (31,132, 12.6%) was most common, followed by LA-A (16,213, 6.6%), LA-B (2333, 0.9%), and ≥LA-C (89, 0.04%). The multivariate-fully adjusted odds ratio (OR) of overall reflux esophagitis for shift work compared to fixed day work was 1.15 (95% confidence interval [CI]: 1.11–1.19). When classified according to shift work type and severity of reflux esophagitis, the ORs of LA-A for regular day and night, and irregular shifts compared to fixed day works were 1.14 (95% CI: 1.03–1.26) and 1.26 (95% CI: 1.11–1.44), respectively. However, there was no significant association between any shift work schedule and ≥LA-B. Overall, we demonstrated the cross-sectional association between shift work (especially rotating and irregular shifts) and mild reflux esophagitis (≤LA-A) compared with daily fixed time shifts.
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Affiliation(s)
- Eunchan Mun
- Department of Occupational and Environmental Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul 03181, Korea; (E.M.); (D.K.); (Y.L.); (W.L.)
| | - Daehoon Kim
- Department of Occupational and Environmental Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul 03181, Korea; (E.M.); (D.K.); (Y.L.); (W.L.)
| | - Yesung Lee
- Department of Occupational and Environmental Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul 03181, Korea; (E.M.); (D.K.); (Y.L.); (W.L.)
| | - Woncheol Lee
- Department of Occupational and Environmental Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul 03181, Korea; (E.M.); (D.K.); (Y.L.); (W.L.)
| | - Soyoung Park
- Department of Occupational and Environmental Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul 03181, Korea; (E.M.); (D.K.); (Y.L.); (W.L.)
- Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul 04514, Korea
- Correspondence: ; Tel.: +82-2-2001-1998
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Cheng Y, Kou F, Liu J, Dai Y, Li X, Li J. Systematic assessment of environmental factors for gastroesophageal reflux disease: An umbrella review of systematic reviews and meta-analyses. Dig Liver Dis 2021; 53:566-573. [PMID: 33339748 DOI: 10.1016/j.dld.2020.11.022] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2020] [Revised: 11/15/2020] [Accepted: 11/16/2020] [Indexed: 12/11/2022]
Abstract
BACKGROUND Side effects of long-term acid suppression have increased the scholars' interest in nonpharmacologic intervention. AIMS We summarized an umbrella review of the association between environmental factors and gastroesophageal reflux disease (GERD) and assessed their credibility. METHODS We appraised systematic reviews and meta-analyses. For each meta-analysis, we considered the effect size, 95% confidence interval, the heterogeneity, small-study effects, P-value for excess significance and largest study significant, then we graded the evidence according to Assessment of Multiple Systematic Reviews and the GRADE assessment. RESULTS 23 publications met the inclusion criteria (13 meta-analyses and 10 systematic reviews), which evaluated 24 environmental factors. Among observational studies, we identified 7 risk factors: overweight/obesity [GERD/erosive esophagitis (EE)/GERD symptom], central adiposity [EE], smoking [GERD], alcohol [GERD/EE/non-erosive reflux disease (NERD)], NSAID [GERD], coffee [EE], Helicobacter pylori eradication [EE], and 1 protective factor: physical activity [GERD], this was based on a suggestive evidence of credibility. Across intervention studies, we identified 1 risk factor-Helicobacter pylori eradication [GERD] and 1 protective factor-breathing exercises [GERD], evidence for both was low grade. CONCLUSIONS We found varying levels of evidence for different environmental factors of GERD. None of them was proven to be convincing or highly recommended.
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Affiliation(s)
- Yuan Cheng
- Beijing University of Chinese Medicine, Beijing, China; Gastroenterology Department, Dongfang Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Fushun Kou
- Beijing University of Chinese Medicine, Beijing, China; Gastroenterology Department, Dongfang Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Jiali Liu
- Beijing University of Chinese Medicine, Beijing, China; Gastroenterology Department, Dongfang Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Yi Dai
- Department of Pharmacotherapy and Oriental Medicine, School of Pharmacy, Hyogo University of Health Sciences, Hyogo, Japan; School of Life Science, Beijing University of Chinese Medicine, Beijing 100029, China
| | - Xiaohong Li
- Gastroenterology Department, Dongfang Hospital, Beijing University of Chinese Medicine, Beijing, China.
| | - Junxiang Li
- Gastroenterology Department, Dongfang Hospital, Beijing University of Chinese Medicine, Beijing, China.
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Zhang M, Hou ZK, Huang ZB, Chen XL, Liu FB. Dietary and Lifestyle Factors Related to Gastroesophageal Reflux Disease: A Systematic Review. Ther Clin Risk Manag 2021; 17:305-323. [PMID: 33883899 PMCID: PMC8055252 DOI: 10.2147/tcrm.s296680] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Accepted: 03/17/2021] [Indexed: 01/30/2023] Open
Abstract
We performed this review to clarify which dietary and lifestyle factors are related to gastroesophageal reflux disease. Through a systematic search of the PubMed, EMBASE, China National Knowledge Infrastructure (CNKI), and Chinese BioMedical Literature (CBM) databases, we identified articles with clear definitions of GERD, including nonerosive gastroesophageal reflux disease (NERD), reflux esophagitis (RE) and Barrett’s esophagus (BE), that included dietary and lifestyle factors as independent factors affecting the onset of GERD (expressed as odds ratios (ORs) or relative risks (RRs) and 95% confidence intervals (CIs)). Due to heterogeneity among the studies, we used descriptive statistical analyses to analyze and synthesize each outcome based on the disease type. In total, 72 articles were included, conducted in ten Western countries (26 articles in total) and nine Eastern countries (46 articles in total). We categorized dietary factors into 20 items and lifestyle factors into 11 items. GERD is related to many irregular dietary and lifestyle habits (such as a habit of midnight snacking: OR=5.08, 95% CI 4.03–6.4; skipping breakfast: OR=2.7, 95% CI 2.17–3.35; eating quickly: OR=4.06, 95% CI 3.11–5.29; eating very hot foods: OR=1.81, 95% CI 1.37–2.4; and eating beyond fullness: OR=2.85, 95% CI 2.18–3.73). Vegetarian diets (consumption of nonvegetarian food (no/yes); OR=0.34, 95% CI 0.211–0.545) and no intake of meat (OR=0.841, 95% CI 0.715–0.990) were negatively related to GERD, while meat (daily meat, fish, and egg intake: OR=1.088, 95% CI 1.042-1.135) and fat (high–fat diet: OR=7.568, 95% CI 4.557–8.908) consumption were positively related to GERD. An interval of less than three hours between dinner and bedtime (OR=7.45, 95% CI 3.38–16.4) was positively related to GERD, and proper physical exercise (physical exercise >30 minutes (>3 times/week): OR=0.7, 95% CI 0.6–0.9) was negatively correlated with GERD. Smoking (OR=1.19, 95% CI 1.12–1.264), alcohol consumption (OR=1.278, 95% CI 1.207–1.353) and mental state (poor mental state: OR=1.278, 95% CI 1.207–1.353) were positively correlated with GERD. RE (vitamin C: OR=0.46, 95% CI=0.24–0.90) and BE (vitamin C: OR=0.44,95% CI 0.2-0.98; vitamin E: OR=0.46, 95% CI 0.26–0.83) were generally negatively correlated with antioxidant intake. In conclusion, many dietary and lifestyle factors affect the onset of GERD, and these factors differ among regions and disease types. These findings need to be further confirmed in subsequent studies.
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Affiliation(s)
- Mei Zhang
- Graduate College, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Zheng-Kun Hou
- Gastroenterology Department, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Zhi-Bang Huang
- Graduate College, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Xin-Lin Chen
- Department of Preventive Medicine and Health Statistics, College of Basic Medical Science, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Feng-Bin Liu
- Gastroenterology Department, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China.,Baiyun Hospital of the First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
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Pizza F, D'Antonio D, Lucido FS, Tolone S, Dell'Isola C, Gambardella C. Postoperative Clinical-Endoscopic Follow-up for GERD and Gastritis After One Anastomosis Gastric Bypass for Morbid Obesity: How, When, and Why. Obes Surg 2020; 30:4391-4400. [PMID: 32621053 DOI: 10.1007/s11695-020-04805-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 06/17/2020] [Accepted: 06/19/2020] [Indexed: 12/18/2022]
Abstract
INTRODUCTION The one anastomosis gastric bypass (OAGB) is a widely diffused surgical procedure for morbid obesity. Several studies considered OAGB at risk for biliary reflux and anastomotic ulcers. The aim of the study was to evaluate gastro-esophageal reflux disease (GERD) and esophagitis/gastritis rate after OAGB diagnosed by upper endoscopy (UE), comparing the results with GERD-Health-Related Quality of Life (HRQL) score. METHODS From July 2014 to February 2019, patients underwent OAGB with at least 12-month follow-up were retrospectively evaluated. Clinical evaluation was associated with GERD-HRQL scoring. UE with a mucosal biopsy was also performed. A comparison among clinical scores and endoscopic findings was performed. RESULTS Two hundred forty-one patients were analyzed in the study. Anthropometric features (BMI, %Excess weight loss, %Total weight loss) were significantly improved. Only 30% of patients with GERD-HQRL>30 showed esophagitis at UE: 11/181 (6.1%) showed grade A erosive esophagitis, 2/181 (1.1%) grade B esophagitis, whereas no patient resulted in grade C/D. Fifty-two patients (28.7%) showed endoscopic remnant gastritis of at least grade 1, with histological gastritis of at least mild grade in 70/181 patients (38.7%). CONCLUSION OAGB is a feasible and effective procedure in terms of weight reduction and comorbidities control, but controversies remain about the long-term onset of GERD and bile reflux. The incidence of esophagitis was increased after OAGB. However, the severity and incidence were lower compared to sleeve gastrectomy. Conversely, the incidence of gastritis, ileo-gastric anastomotic inflammation, and HP positivity were not negligible, suggesting the potential benefits of endoscopic surveillance after OAGB.
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Affiliation(s)
- Francesco Pizza
- Division of General and Emergency Surgery, Asl Napoli 2 nord, Frattamaggiore, Naples, Italy.
| | - Dario D'Antonio
- Division of General and Emergency Surgery, Asl Napoli 2 nord, Frattamaggiore, Naples, Italy
| | - Francesco Saverio Lucido
- Division of General, Mininvasive and Bariatric Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Salvatore Tolone
- Division of General, Mininvasive and Bariatric Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Chiara Dell'Isola
- AORN "dei Colli" Monaldi-Cotugno_CTO Department of Infectious Diseases, Naples, Italy
| | - Claudio Gambardella
- Division of General, Mininvasive and Bariatric Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy
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