Clinical spectrum and risk factors of erosive and non-erosive GERD in health check-up subjects

Kim, Hyun Young; Kim, Nayoung; Kim, Sun Mi; Seo, Ji Hyun; Park, Young Soo; Hwang, Jin Hyok; Kim, Jin Wook; Jung, Sook Hyang; Lee, Dong Ho

Abstract

BACKGROUND: This study was prospectively performed to evaluate the clinical spectrum and risk factors of gastroesophageal reflux disease (GERD) in health check-up subjects.
METHODS
A prospective survey was performed for 752 subjects, aged 18-79 years, who visited the health promotion center. The subjects were asked to complete a questionnaire, and the risk of GERD was calculated by logistic regression analysis with regard to several variables, including smoking, alcohol, exercise, body mass index, fasting glucose, cholesterol, triglyceride and anti-H. pylori immunoglobulin G (IgG). Non-erosive reflux disease (NERD) was defined as the presence of heartburn and/or acid regurgitation for at least once per week.
RESULTS
752 subjects were classified into three groups: 65 erosive reflux disease (ERD) subjects (8.6%), 66 NERD subjects (8.8%) and 621 control group subjects (82.6%). For the 65 ERD subjects, typical reflux symptoms were found in 19 (29.2%), less frequent reflux or atypical symptoms were found in 38 (58.5%) and no symptoms were found in 8 (12.3%). A Los Angeles grade A score was noted in 48 subjects (73.8%), a B score was noted in 11 (17.0%), and a C score was noted in 6 (9.2%). There was no correlation between the grade of reflux esophagitis and the severity of symptoms. The positive rate of H. pylori IgG in the ERD was 36.4%, and this was significantly lower than the rates for the NERD (60%) and control groups (65.3%); this resulted in the odds ratio of ERD in the absence of H. pylori infection to be 5.079 (95% CI: 1.907-13.530).
CONCLUSIONS
The prevalence rate of GERD in health check-up subjects was 17.4%. There was no correlation between the grade of ERD and the severity of the reflux symptoms. The relative risk of GERD in Koreans was significantly low in the H. pylori IgG positive subjects.