J Korean Med Sci.  2021 Feb;36(5):e29. 10.3346/jkms.2021.36.e29.

The Impact of Erosive Reflux Esophagitis on the Decline of Lung Function in the General Population

• Kang HR
• Lee YJ
• Lee HY
• Park TY
• Lee JK
• Heo EY
• Chung HS
• Choi SH
• Kim DK

• KMID: 2512461
• DOI: http://doi.org/10.3346/jkms.2021.36.e29

Abstract

Background
The impact of reflux esophagitis on the decline of lung function has been rarely reported. This study was performed to evaluate the association between erosive reflux esophagitis and lung function changes.
Methods
We included patients with normal lung function who underwent esophagogastroduodenoscopy for health screening from a health screening center. Patients with persistent erosive reflux esophagitis on two discrete endoscopic examinations were designated as the erosive reflux esophagitis group. We also selected patients without erosive reflux esophagitis and matched them 1:4 with patients from the erosive reflux esophagitis group. We estimated annual forced expiratory volume in 1 second (FEV₁ ) and forced vital capacity (FVC) changes from baseline and compared these estimates by the linear mixed regression model. We also estimated the biannual incidence of chronic obstructive pulmonary disease (COPD).
Results
In total, 1,050 patients (210 patients with erosive reflux esophagitis, and 840 matched controls) were included. The median follow-up duration for spirometry was six years. In patients with erosive reflux esophagitis, mild reflux esophagitis (A grade) was most common (165 patients, 78.6%). The adjusted annual FEV₁ change in patients with erosive reflux esophagitis was −51.8 mL/yr, while it decreased by 46.8 mL/yr in controls (P = 0.270).The adjusted annual FVC decline was similar between the two groups (−55.8 vs. −50.5 mL/ yr, P = 0.215). The estimated COPD incidence during the follow-up period was not different between the erosive reflux esophagitis and control groups.
Conclusion
In patients with normal lung function, the presence of erosive reflux esophagitis did not affect the annual declines in FEV₁ or FVC.

Keyword

Gastroesophageal Reflux; Respiratory Function Tests; Forced Expiratory Volume; Vital Capacity; Pulmonary Disease; Chronic Obstructive; Community Health Services

Figure

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  Fig. 1 A study flow chart.GENIE = Gene-environment Interaction and Phenotype, FEV1 = forced expiratory volume in one second, FVC = forced vital capacity, EGD = esophagogastroduodenoscopies, GERD = gastroesophageal reflux disease.

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  Fig. 2 Observed mean change over time in (A) FEV1.and (B) FVC.FEV1 = forced expiratory volume in one second, FVC = forced vital capacity, GERD = gastroesophageal reflux disease.

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  Fig. 3 Adjusted annually changed pulmonary function by LA classification. (A) FEV1 and (B) FVC.LA classification = Los Angeles classification, FEV1 = forced expiratory volume in one second, FVC = forced vital capacity.

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  Fig. 4 Cumulative COPD incidence during follow-up duration.COPD = chronic obstruction pulmonary disease.

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